- Parkview Health (Fort Wayne, IN)
- …annual health risk assessment including completion of required documentation by payer contract if indicated. When appropriate and/or when referred, facilitates ... discussion with patient and family members on advanced care planning directives and services. Helps to identify workflow and operational opportunities for better patient care. Integrates into the clinic and is seen as one of the care team members and a go-to… more
- Covenant Health Inc. (Knoxville, TN)
- …and possible impact on operations. + Ensures compliance with federal, state, and payer regulations while implementing industry best practices. + Works with peers to ... coordinate and oversee all patient access process transition points between patient financial services, onsite patient access services, medical facilities and other areas. Technology & Workflow Optimization + Maximizes the use of front-end technology solutions… more
- Highmark Health (Frankfort, KY)
- …analytics, or customer analytics. + Experience in **healthcare** , payer /provider environment, or other regulated industries (preferred). + Proventrack ... recordanalyzing complex customer and campaign datasets from CRM, CDP, web/app analytics, and marketing automation platforms. + Experience with Adobe Web SDK or Tealium/Freshpaintevent instrumentation. + Background in behavioral science, marketing science, or… more
- Beth Israel Lahey Health (Charlestown, MA)
- …interventions, where inconsistencies can be improved upon and rectified. * Reviews payer denials. Assists in the preparation of appeals to payers, where appropriate. ... * Develops an intervention to prevent subsequent denials for the same problem, where ambiguity or incompleteness of documentation has led to a denial. * Provides ongoing education to Clinical Documentation Specialists on clinical topics. * Periodically reviews… more
- University of Texas Rio Grande Valley (Rio Grande, TX)
- …medical information. Coordinates clinical services provided to patients according to payer guidelines (eg, routing of lab specimens, ordering durable medical ... equipment). + Help maintain an acceptable abandonment (no show) rates. + Perform a variety of clinic specific telephone functions including scheduling and message management. + May be required to provide coverage at other clinical sites as needed. + Performs… more
- R1 RCM (Detroit, MI)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- IQVIA (Phoenix, AZ)
- …existing contracts. . Represent the Managed Markets organization at priority national payer organizations (eg, AMCP, PCMA) . Perform all company business in ... compliance and accordance with all state and federal regulations, and within Company policy and Procedures REQUIRED KNOWLEDGE, SKILLS AND ABILITIES MINIMUM REQUIRED EDUCATION AND EXPERIENCE . Bachelor's Degree and 10 years' relevant… more
- Boehringer Ingelheim (Richmond, VA)
- …implementation and quarterly measurement of the regional business plans. + Monitors payer environment and has in-depth understanding of the processes and mechanisms ... for influencing ILD treatment guidelines through Local, Regional and National pathway companies. + Anticipates how payers integrate pathways into treatment guidelines and develop actionable regional plans which will maximize product penetration. + Initiates… more
- Corewell Health (Grand Rapids, MI)
- …analyzes expenses and profitability of services and programs; analyzes and evaluates payer impact on targeted procedures. + Sets direction and policy to ensure ... organizational culture and department quality outcomes; is accountable for system design and review; personally participates in use of models for improvement; values, encourages, and listens to suggestions from the department staff; is accountable for key work… more
- IQVIA (ME)
- …in a broad spectrum of areas of expertise-providing deep insight into patient, payer , and prescriber behaviors. As a member of the Analytics department, you will ... actively: + Design Analytics and Execute Them: The candidate will acquire knowledge of IQVIA data sources, lead analysis to inform strategic recommendations, develop data analyses systems, and identify trends in complex data sets. + Provide Business Consulting… more
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