- Walmart (Bentonville, AR)
- …(eg immunization, value-based models, network expansion) to expand Walmart's role in payer -provider partnerships. **About the Team:** You'll join Walmart's Payer ... offerings. **What You'll Bring:** + Significant leadership experience in PBM, payer contracting, or network negotiations especially overseeing high-value accounts. +… more
- St Croix Hospice (Sioux Falls, SD)
- …maintains positive working relationships with current and potential referral and payer sources. + Assist in recruitment, selection, orientation, and supporting the ... business development team. + Builds and monitors community, customer, payer and patient perceptions of the organization. + Provides leadership and support to… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …orassistswith finding the correct team for the inquiry. + Answerscomplex payer -related questions. + Coordinates with clinicians and other staff members to ... that all necessary medical information was provided to the third-party payer . + If necessary, helpsclinicalteam understand denial and coordinatesappealprocess. +… more
- UNC Health Care (Lenoir, NC)
- …care plans, tasks or interventions, care transitions, delegated work, and payer communication. The Care Manager works collaboratively with healthcare providers, ... management of patients' care as applicable per patient population. 7. Payer Communication: a. Collaborate with payers, insurance companies, and utilization… more
- CSL Behring (King Of Prussia, PA)
- …Specialty Pharmacies, and distributors for all CSL therapies. Works with payer and channel Customer Account Managers in educating and resolving reimbursement ... for any new products and procedures. + Work with payer and channel Customer Account Managers in educating and...(Specialty Pharmacy) accounts and attend customer account calls with payer and channel CAMs as needed to present reimbursement… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …appropriate Guarantor * Contacts the patient to complete Medicare Secondary Payer Questionnaire for Medicare beneficiaries * Thoroughly documents all conversations ... /*Knowledge/ Skills/ Abilities:*/ * Requires knowledge of government and commercial payer (Insurance) benefit and eligibility verification and ability to become… more
- Ascension Health (Jacksonville, FL)
- …appointments, and answering questions. + Confirm insurance coverage via payer portals and determines necessity for pre-authorization. + Obtain authorization ... required timeframes and assuring referrals are maintained within appropriate network and/or payer requirement. + Remain current on referral policies and procedures, … more
- BrightSpring Health Services (Princeton, WV)
- …including the account names and terms of contracts or other past payer agreements, as appropriate. + Consults with third party representatives regarding client ... interprets potential reimbursement options and negotiates reimbursement levels with third party payer . + Contacts referral sources to advise them of case acceptance… more
- Amgen (Washington, DC)
- …and prioritizing AI use cases across real-world evidence (RWE), payer evidence generation, evidence operations, evidence strategic planning and performance ... state of Access & Evidence Generation processes, including RWE generation, payer evidence, evidence operations, and strategic planning. + Identify and articulate… more
- HCA Healthcare (Nashville, TN)
- …in providing expert billing and coding support to various teams, including payer contracting and analytical teams, payer relations, managed care, legal ... industry data to identify trends and areas for improvement. + Evaluate payer -specific coding guidelines and/or policies upon request, providing clear and actionable… more