- J&J Family of Companies (New Haven, CT)
- …accountable to the institutional contract. + Develop and apply knowledge of payer access and affordability landscape in the territory regarding the company's ... + Interviews with the team: If you move forward, you'll meet with the hiring manager (and possibly others on the team) in one or two interview rounds, depending on… more
- CenterWell (Helena, MT)
- …and Specialty Care to lead strategy and execution for our referral management, payer prior authorization, and specialist network solutions. This role is critical to ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- UNC Health Care (Chapel Hill, NC)
- …Integrity Program. This position will rep ort to the Health Care System Manager of Revenue Integrity and Charge Master. Additionally, the Coordinator is responsible ... complex coding and regulatory requirements in order to understand and analyze payer regulations as well as coding guidelines. Extensive knowledge of Correct Coding… more
- Elevance Health (Los Angeles, CA)
- …data modeling highly preferred. + Functional knowledge across the Healthcare Payer Industry, especially Sales and Customer Relationship Management highly preferred. ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Dignity Health (Chandler, AZ)
- …for our Urgent Care. The MA works under the direct supervision of the nurse manager in caring for the patient and providing the best possible individualized care in ... guidelines. + Provides notes in computer system by documenting all payer related information, patient issues, physician office communications, and any account… more
- PruittHealth (Warner Robins, GA)
- …targets. 2. Analyzes territory, establishes sales goals, and together with sales manager , writes sales plan. 3. Develops business relationships by making effective ... from these sources. 8. Basic knowledge of insurance companies and other payer sources. 9. Supports and participates in promotional activities, sales campaigns and… more
- CenterWell (Topeka, KS)
- …receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices. + ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- Centene Corporation (Olympia, WA)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform on-site visits to assess member's needs and ... or resources, as appropriate + May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions,… more
- Kaniksu Community Health (Sandpoint, ID)
- …+ Monitor and track performance measures, including UDS, HRSA, HEDIS, PCMH, and payer quality metrics. + Collect, validate, and submit quality data for internal ... administrative support to the Population Health Analyst, and Process Improvement Manager . + Gain exposure to leadership and decision-making processes, positioning… more
- Covenant Health Inc. (Powell, TN)
- …documentation in accordance with professional, departmental, organizational, and payer guidelines and timeframes. Maintains established targets for compliance ... per month. + Physician office visits + Community lectures/volunteer + Case Manager visits/marketing + Provide in-services + Follows policies, procedures, and safety… more