- Trinity Health (Boise, ID)
- …contract with SAMG or SAHA and supports compliance with these payer 's pharmaceutical management programs and quality measures. **Communication** : Monitors therapy ... for appropriateness, dosage, effectiveness, interactions, and adverse drug reactions. Works with health care team to optimize pharmacotherapy opportunities, formulary adherence, reduction in poly pharmacy and associated drug cost. Demonstrates knowledge of… more
- UPMC (Pittsburgh, PA)
- …knowledge of electronic data interchange and claims processing, third party payer rules, reimbursement practices and regulatory guidelines. + Proficient with MS ... Word, Excel and Outlook. + Excellent client service skills. + Excellent written and verbal communication skills. + Ability to coordinate projects to meet the needs of users and establish priorities, make decisions and follow issues through resolution. + Strong… more
- UPMC (Williamsport, PA)
- …as a resource for billing, quality, project support, analytics, and payer guidelines. + Problem Solving: Identify recurring problems and procedural deficiencies, ... providing effective solutions to eliminate them. + Process Improvement: Interact with the management team to suggest and implement process improvements. + Root Cause Analysis: Use root cause analysis to address processes that fail to meet departmental and… more
- Trinity Health (Waterloo, IA)
- …learn (eg EMR) + Knowledge of government (Medicaid/Medicare) and third party payer contacts and provider agreements. + Ability to train others. **Our Commitment** ... Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver… more
- Trinity Health (Livonia, MI)
- …Align operations, resources, and strategies for existing programs, physician strategies, payer and regulatory dynamics. Pursue opportunities to grow the segment, ... including new delivery / care / treatment models. Develop and maintain collaborative relationships and partnerships. Conduct market analysis for service expansion and performance. Oversee operations for quality, safety, effectiveness, efficiency, compliance,… more
- Trinity Health (Schenectady, NY)
- …older in zip codes nearby both our centers. Eddy SeniorCare serves as both payer (we provide their Medicare and Medicaid insurance) and provider (offering a full ... range of services--from primary care providers, to home health care, transportation, adult day care, activities, social work, RN case management, nutrition, home delivered meals and medications and medical supplies, and much more!). This is a wonderful… more
- Huron Consulting Group (Chicago, IL)
- …and provides recommendations for mitigation of risk + Extrapolates market and payer trends and coordinates with operational leaders, managed care, vendor management, ... and other relevant stakeholders to support development of action plans to attain top decile metric performance + Develops and manages A/R and performance improvement issues logs, quantifying impact of improvement initiatives, as well as prioritization of… more
- UPMC (Jamestown, NY)
- …KNOWLEDGE AND SKILLS: Must possess knowledge in navigating communications with payer sources and programs. Possess knowledge and understanding of regulatory ... guidelines. Must be skilled in planning/organization, follow up/control, delegation. Problem solving, self-development, organizational behaviors/competencies. Must be able to read, understand, analyze, and interpret medical record documents. Must possess the… more
- Trinity Health (Albany, NY)
- …regulatory and facility's corporate compliance standards + All clinical and payer required documentation is concise, pertinent, legible and in accordance with ... organizational requirements **What you will need:** + Graduate of an approved Physical Therapy program with a Bachelor of Science, Master's degree or Clinical Doctorate of physical therapy degree + Current NYS Physical Therapy license and registration + 1 year… more
- UnityPoint Health (Urbandale, IA)
- …in accordance with hospice conditions of participation (CoPs), various payer hospice coverage criteria, accreditation standards, professional standards for ... discipline/credential and the hospice plan of care. . Maintains accurate and timely documentation of clinical records and time/travel entries Qualifications Education: + Graduate of State Board approved program for Registered Nurses Licensure/Certifciations: +… more
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