- Help at Home (Chicago, IL)
- …Contract Specialist** plays a vital role in supporting provider credentialing, payer enrollment, and contract management across the organization. This position ... ensures providers and entities remain compliant with payer and regulatory requirements while supporting contract accuracy, renewals, and market growth. The… more
- Merck (Bismarck, ND)
- …with internal stakeholders to support seamless patient access to therapy * Monitor payer trends to address access barriers * Provide access information to HCP ... design (Commercial, Medicare, Medicaid) * Answer questions about coverage, including payer -specific access questions * Maintain deep knowledge of regional and… more
- Omaha Children's Hospital (Omaha, NE)
- …supports the interdisciplinary team in aligning treatment goals with payer expectations and evidence-based standards. **Essential Functions** + Utilization ... + Maintain accurate and detailed documentation in the EMR consistent with payer and regulatory standards. + Track utilization metrics and collaborate with leadership… more
- Surgery Care Affiliates (Long Beach, CA)
- …secondary insurance should be added to the patient account ensuring the appropriate payer is selected for Primary insurance. + Utilize the centers selected vendor ... for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or pre-certs and...patient accounting system ensuring the selection is the appropriate payer and associated financial class. + When the patient's… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and ... Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and… more
- Northeast Family Services (Brooklyn, NY)
- …team to drive expansion in new and existing markets, strengthen payer and referral relationships, develop innovative service offerings, and support organizational ... models. + Support contract negotiations and onboarding of new payer or referral partnerships. Payer Relations &...onboarding of new payer or referral partnerships. Payer Relations & Network Strategy + Assess reimbursement environments… more
- Amgen (Charlotte, NC)
- …order to advance the value and clinical knowledge of our products to the payer community. This is a field-based position within the Medical Value & Population Health ... position is within the US business and majority regional accounts and select payer integrated IDNs as assigned. **Responsibilities:** + Provide Payer and… more
- Sanofi Group (Cambridge, MA)
- …a team working cross-functionally to manage the performance of the payer channels, including accountability for tracking and improving targeted account performance, ... execute a robust, evidence-based market access strategy that maximizes payer adoption and patient access to critical therapies. +...overall brand plan. + Plan and manage the Dupixent payer brand budget + Develop and communicate robust market… more
- J&J Family of Companies (Raritan, NJ)
- …Design, develop and implement an integrated approach to all aspects of the payer value proposition from early development through to appointment of a dedicated ... indications. + Responsible for the early strategic planning and implementation of the payer value generation and access strategies. + Serve as the leading resource… more
- Catholic Health Services (Melville, NY)
- …to the patient in advance if an out-of-network status applies. + Ensure payer requirements including the following are met: + Verify and document insurance ... visit information to determine whether authorization is needed and understand payer specific criteria to appropriately secure authorization and clear the account… more
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