- Phoenix Home Care and Hospice (Butler, MO)
- …state and Federal regulations, state practice acts for licenses personnel, payer requirements. + Practices safety, environmental, and/or infection control measures. ... + Performs miscellaneous job-related duties as assigned by Supervisor. Requirements + Physical Therapist Assistant Certification for the state of MO + Home Health experience preferred, not required. + Ability to Pass Drug Test, Background Check, and Physical +… more
- Penn State Health (Hershey, PA)
- …clinical documentation in the EMR, and ensuring compliance with insurance payer requirements for reimbursement. This role requires a thorough understanding of ... health plan insurance criteria. Additionally, the coordinator must have clinical knowledge to assess diagnoses, current conditions, and previous treatments relevant to service approvals. **MINIMUM QUALIFICATION(S):** + High School Diploma or equivalent… more
- CareFirst (Baltimore, MD)
- …and external KPI reporting. + Knowledge of utilization management from a payer perspective is preferred. + Understanding of utilization management processes and ... industry standards is helpful as this role will lead the creation of operational dashboards in PowerBI to support data driven decision making for the business leadership team.Experience in creating dashboards and ensuring accurate reliable data in to be used… more
- Cognizant (Salem, OR)
- …will** . Gather, analyze, and document business requirements for healthcare Payer processes and Salesforce implementations. . Collaborate with stakeholders to ... understand workflows, pain points, and improvement opportunities. . Translate business needs into functional specifications and user stories for Salesforce Health Cloud and related modules. . Work closely with Salesforce developers and architects to ensure… more
- Highmark Health (Baton Rouge, LA)
- …combination of experience and education **Preferred** + 6 years of experience in payer , hospital system, or care delivery industry + Experience with hospital M&A + ... Experience influencing change in complex organizational systems **SKILLS** + Ability to solve complex conceptual and operational problems; potential ability to lead teams in problem-solving exercises + Strong quantitative and analytical skills + Demonstrated… more
- Bayer (Guanica, PR)
- …specialty experience; + Strong knowledge of healthcare management, compliance, payer landscape, market and competitive landscape, commercial and government channels; ... + Strong analytical skills with the ability to create and interpret financial models. Employees can expect to be paid a salary of between $112,080.00 - $168,120.00. Additional compensation may include a bonus or commission (if relevant). Additional benefits… more
- Oracle (Jackson, MS)
- …bring products to market quickly, navigate the regulatory pathway and negotiate payer reimbursement and coverage. KEY OUTCOMES As a Senior Research Consultant, you ... will: + Be the Principal Investigator, lead the design and execution of health outcomes studies including writing research proposals, designing questionnaires, overseeing statistical analysis plan (SAP) development, overseeing data analysis, providing… more
- Presbyterian Homes and Services (Roseville, MN)
- …in electronic medical record. + Demonstrate understanding and knowledge of payer sources and regulatory requirements. + Coordinate with therapist on supervisory ... visit s per regulations . + Communicate effectively with residents/clients, families, caregivers, physicians, referral sources, and interdisciplinary team . Qualifications + Graduate from an accredited Physical Therapist Assistant program. + Current licensure… more
- The Cigna Group (Bloomfield, CT)
- …degree such as MPH, MBA, or MHA is a plus. + Experience in payer , provider, or integrated delivery systems. + Familiarity with value-based care models, population ... health, or digital health tools. + Exposure to strategic planning and healthcare innovation. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider… more
- UPMC (Pittsburgh, PA)
- …is preferred. + Must be able to learn and apply third party payer guidelines and reimbursement practices. + Basic knowledge of health insurance preferred. + ... Must be able to maintain confidential information. + Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.Licensure,… more
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