- Covenant Health Inc. (Knoxville, 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
- University of Utah Health (South Salt Lake, UT)
- …as directed by the attending physician, referring physician and clinical case manager . The incumbent oversees the delivery of individualized services to patients and ... outcome, expected cost and then recommendeds a discharge plan. + Ensures the payer is represented in staffing conferences when requested. **Knowledge / Skills /… more
- Catholic Health Initiatives (Omaha, NE)
- …system, insurance benefits, and all account comments; applies knowledge of payer contracts and experience with insurance reviews to gather additional information ... posting log and quarterly cash handling audits and reports findings to Supervisor/ Manager . **Job Requirements** Required + Education - NONE **Where You'll Work**… more
- Elevance Health (Granite Falls, NC)
- …(DSS), service providers, and other stakeholders preferred. + Experience working in payer space directly with providers preferred. Please be advised that Elevance ... 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
- Sevita (Columbus, OH)
- …(MCOs, state referrals) and escalates potential issues (eg, unresponsive case manager , etc.); approves referral decisions to admit individuals into our services, ... targets. 2. Scouting: Responds to local requests for proposals to address payer needs; identifies and participates in new start development initiatives as… more
- CVS Health (St. Paul, MN)
- …savings and margin growth. + Provides strategic counsel to the General Manager on pharmaceutical market dynamics, including emerging therapies, pricing trends, and ... rebate contracting, and cost containment. + Familiarity with healthcare regulations and payer -provider dynamics. + Strong business acumen with a track record of… more
- ChenMed (Miami, FL)
- …Learning (ML) driven solutions based on a rich stream of clinical, claims, payer , and behavioral data. The Senior Data Scientist operates in a highly collaborative ... and techniques. + Performs other duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS AND ABILITIES:** + Keen business acumen and acuity… more
- Kaleida Health (Buffalo, NY)
- …skills, as well as possess a thorough understanding of external, regulatory, payer and other forces impacting healthcare financial operations. Expected to organize ... Revenue Cycle related functions and/or Finance required. 5 years of Manager /leadership experience in health care, with knowledge of revenue cycle operations,… more
- UPMC (Wexford, PA)
- …hours per week. Purpose: Typically, function under the direction of the Supervisor/ Manager responsible for patient access. Schedule appointments for a similar group ... is preferred. Must be able to learn and apply third party payer guidelines and reimbursement practices. Basic knowledge of health insurance preferred. Must… more
- MedKoder (Mandeville, LA)
- …and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding ... client remotely and on-site; + Communicate with the Physician Audit and Education Manager on issues, trends, and audit timeline task completion; + Stay current on… more