- Sanofi Group (Morristown, NJ)
- …regional impact, delivering US specific evidence generation and dissemination, shaping payer and policymaker dialogue, and ensuring HEVA evidence directly influence ... strategies. + Translate HEVA evidence into business and policy impact-driving payer engagement, value positioning, and access strategies. + Anticipate and… more
- Community Health Systems (Antioch, TN)
- …to improve claims resolution, reduce future denials, and ensure compliance with payer guidelines. **Essential Functions** + Monitors assigned denial pools and work ... on denials and appeals. + Conducts follow-up calls and payer portal research to track the status of submitted...notes, and tracking reports. + Ensures compliance with all payer guidelines and regulatory requirements, keeping up to date… more
- Community Health Systems (Franklin, TN)
- …Functions** + Submits initial assessments, continued stay reviews, and payer -requested documentation, ensuring compliance with policies, regulations, and payer ... documentation of escalations, avoidable days, authorization numbers, denials, and payer interactions to ensure accurate records. + Coordinates Peer-to-Peer… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …This role will be responsible for delivering technology solutions that enable payer engagement, pricing strategy, health economics and outcomes research (HEOR), and ... as the primary IT partner for the **Access & Value** team, including Payer Strategy, HEOR, Pricing & Contracting, and Government Affairs. + Translate business needs… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …Pricing, and Contracting and is responsible for developing and executing US payer and provider contracting strategies, tactics, and initiatives in partnership with ... ecosystem assessments including market research to understand the landscape from payer , patient, and provider perspectives + Inform and recommend future… more
- McLaren Health Care (Mount Pleasant, MI)
- …issue resolution, process improvement initiatives, and response to inquiries to payer denials . **Essential Functions and Responsibilities as Assigned:** 1. Supports ... the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered. 4.… more
- University of Rochester (Rochester, NY)
- …Communicate direction and financial data to guide new program development. Provide payer data needed for business plans and/or budget to support the purchase ... expanding service lines. Ex. Donor milk, Telemedicine. **(20%)** + Partner with URMFG Payer Enrollment group and the Medical Staff Services Office to credential new… more
- Abbott (Austin, TX)
- …managing clinical trial reimbursement processes to secure Medicare and private payer reimbursement for designated clinical trials. This position will operate with ... (CTR). **What You'll Work On** + Review clinical investigative plan and payer policies (Medicare, Medicare Advantage, Medicaid and Private Payer ) to… more
- Publicis Groupe (Morristown, NJ)
- …with tackling a labyrinth of payers and organized customers, with limited resources, payer marketers can sometimes feel trapped between a rock and-well you know. ... to rock in a hard space. Since day one, Payer Sciences has approached managed markets from a different...in sharp minds and multiple perspectives. To that end, Payer Sciences has assembled a flat and flexible organization,… more
- Danaher Corporation (Portland, OR)
- …a provider / customer facing role responsible for delivering compliant payer coverage, coding and reimbursement information regarding Cepheid on market diagnostics. ... issues for Medicare, Medicaid and Commercial payers through internal meetings, payer research, and customer meetings. + Proactively and reactively navigate and… more
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