- Essentia Health (Fargo, ND)
- …contracted insurance networks and subnetworks. Understands CMS Medicare, Medicaid, and managed care billing, credentialing and enrollment requirements and ... and credentialing for various practitioner's groups and specialties for which contracting services are providedCompletes audit of signed enrollment applications and… more
- HCA Healthcare (Las Vegas, NV)
- …experience in an acute care hospital. Utilization Review, appeals, denials, managed care contracting , experienced preferred. + Currently licensed as ... policy and procedure. + Demonstrates a working knowledge of managed care agreements based on available resources...resources which may include and not be limited to payer UM Manual, policy and procedure, facility contract information.… more
- Sanofi Group (Morristown, NJ)
- …the short and long-term transplant market access strategy (positioning, pricing, contracting , pull-through plans) from start to end, for national/regional payers, ... and patient support services. The candidate will utilize portfolio expertise and managed markets experience to build an integrated market access strategy based upon… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Proactively review and report on product line contribution margin and payer reimbursement changes for EHC. + Provides analysis with recommendations to decision ... Services Department, other EHC entities and leadership. + Develops reimbursement contracting standards. + Actively participates in various committees that address… more
- Evolent (Hagatna, GU)
- …least 5 years of professional experience in claims-based healthcare analytics with a payer , provider, vendor, managed care , or related healthcare consulting ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Catholic Health Initiatives (Houston, TX)
- …Consistently monitors and updates information regarding insurance data, physicians, authorizations and managed care contracting . 6. Assists patients and ... and clinical excellence that has given rise to breakthroughs in cardiovascular care , neuroscience, oncology, transplantation, and more. Our team's efforts have led… more
- BrightSpring Health Services (Springville, AL)
- …contract negotiations with agencies, funding sources, facilities, insurancecompanies, and managed care organizations* Supports and promotes company philosophy ... and retention metrics, and ongoingtraining and development.* Routine collaboration with payer contracting to negotiate the most advantageous contractspossible.*… more
- Elevance Health (Sacramento, CA)
- …+ Travels to the worksite and other locations as necessary preferred. + Managed care experience preferred. For candidates working in person or virtually ... autism and depression, and insightful analytics to improve the delivery of care . The **Provider Quality Manager** is responsible for leading Behavioral Health (BH)… more
- CVS Health (Hartford, CT)
- …the following key attributes: + 15+ years of experience in managed care ; leading and managing teams. + Experience contracting with providers and hospital ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- University of Rochester (Rochester, NY)
- …for continuous coverage on all Medicaid, Out of State Medicaid, and Medicaid Managed Care cases for appropriate follow-up and timely referral to Medicaid ... Management, Utilization Management, Social Work, Patient Accounts, Medical Records, Home Care Coordinators, Prior Authorization Teams, Contracting and Finance. +… more