- Amgen (Denver, CO)
- …this. Let's change the world. In this vital role you will be the liaison to our customers by providing clinical knowledge of our products to medical professionals. ... resources, and activities within the territory . Demonstrates knowledge of local payor coverage . Ability to understand and articulate clinical concepts, data, and… more
- Ascendis Pharma (Princeton, NJ)
- …Coast hours. Key Responsibilities + Independently review/approve promotional, medical, payor , corporate, and other non-promotional materials to assess for regulatory ... pre-approval and/or disease education communications + Serve as the company's regulatory liaison to the FDA's Advertising and Promotional Labeling Branch and Office… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …Collaborate with leadership to address operational inquiries and act as a liaison with TPAs, wholesalers, and manufacturers to ensure alignment on audit deliverables ... or compliance. Validate TPA rules/logic are current and loaded correctly by payor + Track manufacturer restrictions and policy changes related to contract pharmacies… more
- St. Luke's University Health Network (Allentown, PA)
- …documented medical care for appropriate reimbursement. + Work with the physician liaison in review of patient medical records identified by RAC/MIC/CGI/QIO and other ... professionals and be able to refute the coding determination made by the outside payor including but not limited to CMS, Aetna, IBC, Omniclaim, QIP, Gateway Health,… more
- Guthrie (Sayre, PA)
- …Clinic to internal and external organizations, including government agencies, payor organizations, vendors, external auditors, and business partners. Education, ... to ensure pricing transparency and regulatory adherence. + Serve as a liaison between revenue cycle and clinical departments to educate and support providers… more
- Eastern Connecticut Health Network (Vernon, CT)
- …Resource for early intervention, need for cooperative relationships. + Serves as a liaison between referral sources. + Assist with payor information and ... verification process. + Performs other duties as assigned. + Responsible for overseeing and managing the performance of the referral nurses in the department. #LPECHN more
- Houston Methodist (Houston, TX)
- …strategic objectives for the Utilization Management Program and serve as the liaison to other medical staff committees that interface with the utilization ... the continuum of care. Facilitates, mentors, educates other physicians regarding payor requirements and lnterQual Criteria and CMS guidelines for medical necessity.… more
- Northern Light Health (Bangor, ME)
- …Residency RN will need to act a not only as a patient advocate and liaison but must also operate with the understanding that they are working with inexperienced ... services and intervenes as indicated. * Maintains an expert working knowledge of payor /reimbursement systems as part of the utilization process. GROWTH * Seeks and… more
- CareFirst (Baltimore, MD)
- …of departmental budget to control and appropriately allocate resources. + Act as a liaison between the business units and the risk adjustment group by promoting a ... **Experience:** 5 years experience of progressive responsibility in a healthcare payor environment. 1 year experience with supervisory or demonstrated progressive… more