- Humana (Louisville, KY)
- …patient safety, and peer review matters + wide variety of contracting matters, including payor, accountable care organization (ACO), independent physician ... association (IPA) and value-based care arrangements for primary care and home health services + Medicare billing, enrollment, and conditions of participation rules + coding/reimbursement and revenue cycle management + assisting in compliance reviews of… more
- Dana-Farber Cancer Institute (Boston, MA)
- …including utilization review, intake or discharge planning, and managed care contracting . This role ensures the delivery of high-quality patient care by ... We conduct groundbreaking research that advances treatment, we educate tomorrow's physician /researchers, and we work with amazing partners, including other Harvard… more
- University of Michigan (Ann Arbor, MI)
- …staff. Collaboration & Representation + Partner with Finance, Revenue Cycle, and Contracting to optimize clinical and financial outcomes. + Collaborate with ... physician advisors, community agencies, and post-acute partners to ensure effective transitions of care. + Represent Care Management and Social Work on institutional… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …business units, but are not limited to: + CPRC/S membership + Healthcare Contracting and Management Team + Legal Department: + Medical Directors + Member Appeals ... Grievance Programs (Commercial, Medicare Advantage, and InterPlan Program) + Physician Review Units + Prepare documentation in response to regulatory inquiries (eg,… more
- BD (Becton, Dickinson and Company) (CA)
- …for achieving sales objectives through targeted customer engagement, negotiation, contracting , training and general sales support. This position will have ... needed) gaining exposure to US healthcare; specifically laboratory, nursing and physician engagement advancing ones' BD Way of Selling and business/industry acumen.… more
- CommonSpirit Health (Rancho Cordova, CA)
- …situations, as the work may have a direct impact on individual physician incomes, along with directly impacting the financial performance of CommonSpirit Health. ... associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop and approve financial models and payer… more
- ChenMed (Miami, FL)
- …positive economic impacts & other strategic benefits + Accountable for scoping, contracting , and executing high-value vendor partnerships. + Performs other duties as ... for seniors and changing America's healthcare for the better. Family-owned and physician -led, our unique approach allows us to improve the health and well-being… more
- Providence (Spokane, WA)
- …and administrative leaders for enterprise capital planning, vendor selection, contracting , digital solutions, care pathways, and KPI development alongside Finance ... is preferred. + **Relationship Builder:** Proven track record of successful physician relationships and collaboration across large health systems or regions. +… more
- ChenMed (Atlanta, GA)
- …Familiarity with healthcare network strategy, including network development, value-based care contracting , provider relations and local operations + Must be driven ... for seniors and changing America's healthcare for the better. Family-owned and physician -led, our unique approach allows us to improve the health and well-being… more
- Providence (Irvine, CA)
- …Systems Expertise:** Experience within complex, matrixed healthcare systems, including physician groups, health plans, and long-term care. + **Business Acumen:** ... Knowledge:** Understanding of federal/commercial payor reporting requirements and third-party contracting , including expertise in Medi-Cal. + **Reimbursement Models:** Familiarity… more