- University of Utah Health (Murray, UT)
- …exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, ... accurate and complete risk score capture in ACA (Marketplace), and Medicaid populations. + The position will collaborate cross-functionally with clinical, coding,… more
- Danaher Corporation (Orlando, FL)
- …understanding of national, regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through internal meetings, payer ... or diagnostics (preferred) + Demonstrated knowledge of all payer segments (eg Commercial, Medicare , Medicaid ) + Demonstrated and presentation skills It would be… more
- CVS Health (Springfield, IL)
- …(PA) and/or medical necessity appeals for commercial clients, governmental ( Medicare / Medicaid ) programs and individual client requested coverage determinations ... decisions. If specifically assigned to one business segment (ie, Medicare clients), each director will become sufficiently skilled in...you'll perform a share of special clinical investigations and research as requested by the Senior Medical… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …(US) healthcare systems, health policy, including managed care organizations, IDN's, Medicare and Medicaid ; innovative reimbursement pathways, similar awareness ... region value-based market strategies integrating reimbursement, health economics, outcomes research and market access solutions across product stages and lifecycles.… more
- Takeda Pharmaceuticals (Boston, MA)
- …Experience and in-depth knowledge in obtaining reimbursement withthird party commercial payers, Medicare Parts D and B, Medicaid , VA/DOD, integrated payer ... appropriate reporting and compliance + Chair the Pricing Committee (comprised of senior leadership from sales,patient value & access, marketing, finance and legal)… more
- University of Michigan (Ann Arbor, MI)
- …sources such as Vizient, Pediatric Health Information System (PHIS) and Center for Medicare & Medicaid Services (CMS) benchmarking. **Skills You Have** + ... to provide insights for adult and pediatric hospital financial initiatives to senior leaders across the system. Supports analytic design, data collection, and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …and reimbursement systems. + In-depth knowledge of healthcare regulations, including Medicare and Medicaid billing and medical record documentation requirements. ... is a leader in life changing breakthroughs in cancer research and patient care. We are united in our...ensure ongoing compliance. Prepares and presents review findings to senior management and recommends corrective actions. + **Training and… more
- University of Colorado (Aurora, CO)
- …in order to obtain full prescriptive authority and DEA registration. + Medicare / Medicaid credentials. + Unrestricted DEA license. + National certification by ... needed. + Disseminate information to health care professionals about health care issues. ** Research ** + May participate in clinical research and other scholarly… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …computations, diagnostic coding gap identification, benchmarking, and confidence modeling across Medicare , ACA, and Medicaid . * Manages operational metrics, ... opportunities. * Effectively communicates insights, strategies, and analytics to senior leadership and stakeholders, ensuring alignment with Blue Cross's long-term… more
- Evolent (Helena, MT)
- …in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... for utilization management while working in conjunction with the Senior Medical Director. **Qualifications - Required and Preferred:** +...by any state or federal health care program, including Medicare or Medicaid , and is not identified… more