- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …Strategy will own specific accounts and business segments (either IDNs, GPOs, Payer ) for the purpose of strategy development. The Director, Contract Strategy is ... a proven leader supporting the development, refinement of Payer /GPO contracting strategy for the Ophthalmology portfolio, including traditional rebate agreements and… more
- Bozeman Health (Bozeman, MT)
- …corrected or replacement claims, and combining hospital accounts in accordance with payer billing policies. Monitor, resolve or escalate payer denials, returned ... claims, claim edits, correspondence and report payer claim processing behavior to assist with identifying systemic issues that may require process improvement to… more
- CommonSpirit Health (Phoenix, AZ)
- …used for care coordination, risk stratification, quality improvement, and payer -provider integration, ensuring alignment with the organization's value-based care and ... strategies related to value-based care, ACOs, Medicare Advantage, Medicaid, and commercial payer programs. Oversee integration of clinical and claims data to support… more
- Lundbeck (Deerfield, IL)
- …status and program eligibility + Educate providers and key stakeholders on payer processes and procedures + Meet face-to-face or virtually to answer technical ... a deep subject matter expert on the local market access expertise including payer landscape for Lundbeck specialty products + Provide education to accounts and field… more
- UCLA Health (Los Angeles, CA)
- …(URAC, BOP, ACHC), and ensure compliance with all regulatory and payer standards. You will supervise pharmacists and pharmacy technicians, maintain efficient ... pharmacy services + Supporting LDM (limited distribution medication) strategies, payer initiatives, and operational performance improvement + Supervising staff to… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Contract Variance Analyst provides foundational support in managing appeals related to payer contract variances and fatal denials. This role is responsible for ... an opportunity to build expertise in revenue cycle operations and payer relations while ensuring compliance with organizational and regulatory standards.… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …ensuring timely resolution through proactive coordination with internal stakeholders and payer representatives * Conducts advanced research and analysis to support ... appeal documentation, staying abreast of payer policies, regulatory changes, and industry trends * Serves...in contract variances and denials, providing insights to inform payer negotiations and operational improvements * Develops and presents… more
- Insight Global (Newtown Square, PA)
- …and enforce data quality policies, standards, and KPIs aligned with payer business processes. o Collaborate with business stakeholders (Claims, Provider Network, ... o Databricks (Spark, Delta Lake, notebooks) . Experience in healthcare payer domain (claims, eligibility, provider data, etc.). . Excellent communication,… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …for admission to Hospice care according to Medicare, Medicaid, and third-party payer guidelines. + Maintain discretion, as the position could be exposed to ... and significant others. + Ensure maximum reimbursement through initial payer source, benefits, eligibility verification, and authorization processes. + Provide… more
- Albany Medical Center (Albany, NY)
- …registration + Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility + Responsible to ... to maintain the Electronic Health Record + Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration. + Ability to work… more