- Sharecare (San Juan, PR)
- …Summary:** CareLinx is looking for a Care Advisor to assist with CareLinx's Payer Operations line of business. CareLinx is a healthcare technology platform that ... connects families with non-medical, in-home caregivers, and Care Advisors provide support and guidance to families during the caregiver search, interview, and hire process. Once a caregiver match is made, the Care Advisor will follow closely to ensure… more
- Cognizant (Pierre, SD)
- …PowerShell and Ansible + Possess a deep understanding of the Payer domain applying domain-specific knowledge to infrastructure solutions. + Exhibit excellent ... problem-solving skills with the ability to analyze complex issues and develop effective solutions. At Cognizant, we're eager to meet people who believe in our mission and can make an impact in various ways! We strongly encourage you to apply even if you only… more
- Highmark Health (Tallahassee, FL)
- …evolution of critical database systems that underpin both our provider and payer side operations. Candidates should be capable of working independently on routine ... database administration tasks, troubleshooting issues, and collaborating effectively with application teams and vendors on customer projects with limited guidance. Duties include + **Database Operations & Performance:** Manage the day-to-day operation,… more
- Evolent (Honolulu, HI)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... + Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs + Exceptionally strong analytical abilities, with track record of identifying and communicating insights from… more
- AdventHealth (New Smyrna Beach, FL)
- …benefit is achieved or according to standards of practice and payer guidelines. Participates in practice changes resulting from performance improvement activities ... and supports departmental quality standards and initiatives. Participates in practice changes resulting from performance improvement activities and supports departmental quality standards and initiatives. Oversees the care provided by physical therapist… more
- Evolent (Tallahassee, FL)
- …5 years of professional experience in claims-based healthcare analytics with a payer , provider, vendor, managed care, or related healthcare consulting entity . ... Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service . Previous Experience with healthcare reimbursement methodologies and calculations such as Fee for Service,… more
- BayCare Health System (Oldsmar, FL)
- …timely turnaround for authorizations. Utilize electronic scheduling/registration/financial systems, payer 's websites, and recorded calls to validate health coverage ... and benefits in processing approval for medical services. Maintain proper documentation in Soarian or GE systems. Work closely with Managed Care and understands health insurances rule sets, manuals, and contract language. **Why BayCare?** Our network consists… more
- AdventHealth (Parker, CO)
- …benefit is achieved or according to standards of practice and payer guidelines. Participates in practice changes resulting from performance improvement activities ... and supports departmental quality standards and initiatives. Participates in practice changes resulting from performance improvement activities and supports departmental quality standards and initiatives. Oversees the care provided by physical therapist… more
- PeaceHealth (Vancouver, WA)
- …on **concurrent and retrospective UM reviews** , leveraging clinical expertise, payer policy knowledge, and technology tools to guide patient status determinations ... and promote appropriate utilization of hospital resources. You'll work fully remote*, with PeaceHealth-provided computer equipment-empowered by a collaborative team, supportive leadership, and a strong organizational commitment to diversity, cultural humility,… more
- Evolent (Lansing, MI)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... + Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs + Exceptional analytical and communication skills with the ability to identify and translate insights from… more