- Organon & Co. (Dover, DE)
- **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director, Regional Payer Accounts. The RPAD ... relationships through productive business relationships as well as profitable contracts and programs. The primary customer/account responsibilities include key… more
- Fallon Health (Worcester, MA)
- …in a managed care payer preferred. * One year experience as a case manager in a payer or facility setting highly preferred. * Relevant experience may include ... **Overview** **This is 3 months temporary contract position for a Prior Authorization RN.** **About...Keeps records and submits reports as assigned by the Manager * Refers high-risk cases to the appropriate FH… more
- University of Rochester (Rochester, NY)
- …support and direction to the team. + Trains staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital and ensure ... account notes and adjustments. + Attends monthly team meetings with the Outpatient Manager and appropriate payer representatives. + Runs, distributes and ensures… more
- Robert Half Accountemps (Taunton, MA)
- …high balance accounts and report any account activity concerns to the Billing Manager . * Stay informed about payer specifications and independently research ... Billing Clerk to join our team on a long-term contract basis in Taunton, Massachusetts. In this role, you...claims reconciliations and resolve issues independently. * Knowledge of payer specifications and timely filing requirements for claims. *… more
- Takeda Pharmaceuticals (Boston, MA)
- …and process rebates and fees within ModelN FLEX revenue management system for both Payer and GPO contracts . Support data requests from US OBU Patient Value ... bring all issues to a satisfactory resolution. + Gather Payer claim level data files, reconcile Payer ...experience in the pharmaceutical industry required. + ModelN/Flex Revenue Manager experience in contract implementation and maintenance… more
- University of Utah Health (Salt Lake City, UT)
- …management.** **- Analytical (data trends) and reporting.** **- Understanding of payer contracts and reimbursements.** _As a patient-focused organization, ... accounts. + Develops and manages escalation pathways for unresolved claims or payer disputes. + Implements process improvements for admissions, billing, third party … more
- Guthrie (Sayre, PA)
- Summary The Denial, Appeal, and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes within the ... of claim denials, effective appeal strategies, and proactive audit response. The manager leads a team of specialists, coordinates with internal departments, and… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …supports the redline process to commit agreed upon deal terms to executed contracts . **A typical day may include:** ** Contract Strategy Management and ... The Contract Strategy team has responsibility for developing contracting...own specific accounts and business segments (either IDNs, GPOs, Payer ) for the purpose of strategy development. The Director,… more
- Mount Sinai Health System (New York, NY)
- …Experian Contract Manager Tool to determine financial performance. + Model Payer Proposals in Experian Contract Manager Tool. + Reconcile budgeted ... within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for...Own the development and execution of pricing strategies in payer contract negotiations. + Mentor analysts in… more
- Ascendis Pharma (Princeton, NJ)
- …specialty pharmacy, and/or GPO agreements (eg, rebate, discount, and data sharing contracts ). + Operational Execution: Oversee contract set-up, terms validation, ... their skills. Position Summary: We are seeking a highly motivated Senior Manager to support our Contracting Operations function within the Market Access… more