- HCA Healthcare (Nashville, TN)
- …communities. As an AVP Managed Care with Surgery Ventures, you can be a manager in an organization that is devoted to giving! **Benefits** Surgery Ventures offers a ... VP of Managed Care Ambulatory Surgery, the CVP of Payer Contracting and Alignment ("PCA") and on behalf of...system-wide managed care department to successfully negotiate managed care contracts for HCA. The AVP of Managed Care is… more
- John Muir Health (Walnut Creek, CA)
- …policies and processes. Serves as the business lead for all pharmacy payer contracts , ensuring appropriate access to commercial and government agreements. ... business performance. (eg Vizient ODB, CDB) Establishes and monitors 340B contract pharmacy agreements and relationships to ensure full compliance and maximize… more
- University of Washington (Seattle, WA)
- …to reimburse the UW Medicine for services in accordance with the payer -provider contract , and works diligently toward the identification, mitigation, and ... provided at the Medical Centers. **PRIMARY JOB RESPONSIBILITIES** + Document all payer communications thoroughly, and communicated payer decisions in a timely… more
- Novo Nordisk (Traverse City, MI)
- …current co-promotion partners. Internally, the CMCS I reports to the District Business Manager of the specific sales territory. The CMCS I also interacts and ... basis with territory level impact + Demonstrates understanding of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer … more
- Lilly (Indianapolis, IN)
- …product pricing, reimbursement, and access (PRA), grant submissions and contracts ; contacts with regulatory and other governmental agencies; outreach medical ... and Value Proposition that addresses key customer needs (patient, provider, and payer ); the product lifecycle plan, clinical strategies, development plans and study… more
- Option Care Health (Columbia, SC)
- …considered Responsible for the timely, accurate submission of invoices to responsible payer , of any type, for all services and products provided. Evaluates payments ... **Job Description:** **Job Responsibilities:** + Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee… more
- Catholic Health (Kenmore, NY)
- …for delays of treatment. This individual also works to maintain third-party payer relationships related to Utilization Review Activities. This includes, but is not ... between parties. Knowledge of state and federal laws relating to contracts and utilization review process processes is vital. Responsibilities: EDUCATION +… more
- Tidelands Health (Myrtle Beach, SC)
- …a clean claim including special billing procedures that may be defined by a payer or contract . + Review and resolve account checks, clearinghouse rejection ... + Analyze clinical data and interpret information. + Have knowledge of payer guidelines related to MUE, Medical Necessity, LCD/NCD requirements and HIPAA/Compliance… more
- Open Mind Health (NE)
- …policies to ensure smooth operations and high compliance. + Assist with periodic payer contract reviews. + Actively seeks continuous quality improvement and ... LOCATION: REMOTE REPORTS TO: CLIENT LIAISON MANAGER ABOUT OPEN MIND HEALTH We are a...ongoing monitoring. + Has worked with a variety of payer portals including Aetna, Blue Cross Blue Shield, Optum,… more
- Rochester Regional Health (Rochester, NY)
- …patient services. Under the general supervision of the Patient Access Services Manager , this position performs imperative duties including registration pre and full, ... insurance coverage, eligibility, and benefits; complete required Medicare and payer documentation; collect patient-pay balances; resolve registration errors; and… more