- Baylor Scott & White Health (Dallas, TX)
- …and managed care payers, ensuring all processes comply with regulatory and payer requirements. The Director, Provider Enrollment guides the management team and staff ... to ensure facility enrollment applications are submitted promptly and payer provider numbers are obtained timely, supporting accurate and efficient payer … more
- Mount Sinai Health System (New York, NY)
- …of experience in healthcare analytics required + 4 years? experience with payer pricing models and payment methodologies required. + 4 years? experience developing ... and executing payer pricing strategies required. + Health plan experience in...modeling, payment methodologies, pricing strategy, market competitive intelligence and payer negotiation strategies. + Own the development and execution… more
- Takeda Pharmaceuticals (Boston, MA)
- …future products. You will also be responsible for value story development, payer /PBM contracting strategy, pricing, specialty pharmacy and distribution plans, and ... payer /channel marketing resources for in-line and pipeline products. **How...(HEOR), Marketing, Finance, Analytics, and Sales to capture relevant payer and channel insights, identify data gaps, develop compelling… more
- Intermountain Health (San Juan, PR)
- …goal of account resolution. + Utilize resources to find payment documentation- Interpret payer contracts to ensure all codes on patient's account match contracts. + ... Initiates payer recoupments, payer refunds, and patients refunds where applicable. Follows up in accordance with procedures and policies with an overall goal of… more
- 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
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