- University of Rochester (Rochester, NY)
- …compliance with State and Federal Regulations, accreditation standards and third-party payer requirements for the purpose of minimizing risk and exposure. This ... business, market growth, service development and payor/PBM strategies. + Participates with payer contracting leaders of the health system in the evaluation and… more
- Genesis Healthcare (PA)
- …expert** for the market, supporting the Market President and center teams on all payer types, with priority on Medicaid Pending and Private accounts. + Oversee and ... performance. + Conduct regular reviews of collections, outstanding receivables, and payer -specific trends; develop and execute corrective action plans. + Supervise… more
- East Boston Neighborhood Health Center (Revere, MA)
- …to enroll a provider with the payers and the requirements of each payer . + Gathers and disseminates information to appropriate administrative stakeholders to ensure ... is accurate and up to date every 90 days to avoid delays with payer credentialing and recredentialing. + Answers phone calls and other inquiries regarding Medical… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …commercialization activities, including the preparation of HTA submissions and addressing payer requirements. * Evaluate HTA decisions and apply insights to pipeline ... and marketed products, ensuring submissions meet regulatory and payer expectations for value demonstration and reimbursement. * Report, publish, and present HEOR… more
- Community Health Systems (Franklin, TN)
- …financial audits (eg, SOX implications), or compliance with GPO contracts and payer rules. + Revenue Leakage Identification: Specifically focus on validating the ... or analytics role, working within a large healthcare system, hospital, or payer environment. + Deep Oracle Domain Expertise (Mandatory): Proven practical experience… more
- University of Rochester (Rochester, NY)
- …at improving financial performance in VBP contracts and other third party payer contractual agreements. + Fosters effective communication with employees, peers, and ... health and special populations, capital infrastructure development, network and payer relationships, innovative academic programs needing faculty and fellow… more
- BJC HealthCare (St. Louis, MO)
- …authorization process, this team member will initiate contact with provider offices, payers and/or payer websites as well as access a variety of systems and tools to ... records may be required if initiating the authorization request directly with a payer . + BJC has determined this is a safety-sensitive position. The ability to… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …LOS is authorized, chart is coded and claim is billed and is in the payer system and will pay at expected reimbursement. + Ensures that billing packets are scanned ... Knowledge and Experience: + Knowledge of governmental and managed care payer requirements. + Demonstrates sound leadership skills. + Knowledge of management… more
- UNC Health Care (Morrisville, NC)
- …care pre-claim and post claim denial rates, readmission, and analyze and track payer methods to deny or reduce payment. Pinpoint savings opportunities and deploy ... electronic medical record (EMR) and Care Management technology, hospital coding/billing, payer contracting, and Revenue Cycle management. + Advanced skills in data… more
- Cedars-Sinai (Beverly Hills, CA)
- …applies data-driven methodologies to improve specialty pharmacy operations and monitor payer formulary and access changes. This position ensures compliance with ... monitoring quality and safety outcomes, engaging with external stakeholders regarding payer and limited distribution drug access, and managing data reporting to… more