- Elevance Health (Indianapolis, IN)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **Primary duties may include, but are not limited to:** + Claim reviews… more
- CenterWell (Boston, MA)
- …Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- State of Massachusetts (Boston, MA)
- …partner to the state hospital system and the State Office of Pharmacy Services (SOPS). This leadership role ensures that the Commonwealth's multi-specialty hospitals ... (PHH) Bureau, including the public health hospitals and the State Office of Pharmacy Services (SOPS). . Provide comprehensive legal counsel and written opinions to… more
- PeaceHealth (Vancouver, WA)
- …conferences_ + _Internal training with CE eligibility_ + _Connections to top professional affiliations_ + _Access to resource libraries, webinars, and subject matter ... operational leadership to a team of clinical risk managers and senior clinical risk managers, ensuring effective identification, evaluation, mitigation, and… more
- Mount Sinai Health System (New York, NY)
- …**Responsibilities** 1. Analyzes data requests using information technology, enrollment, claims , pharmacy , clinical, contract, medical management, financial, ... Corporate Offices** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization...care EMR such as Epic/Clarity, eCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more
- Ford Motor Company (Dearborn, MI)
- …competitive positioning. + Develop business cases and financial models for senior leadership on benefit investments, plan redesign, and transformational initiatives. ... & Collective Bargaining Leadership:** + Serve as the lead strategist and senior negotiator for health care benefits in collective bargaining, shaping proposals that… more
- Hawaii Pacific Health (Honolulu, HI)
- …Revenue Cycle Task Force committees and processes for Hospital, Physician, Pharmacy , Pacific Islanders, Worker compensation, and direct oversight and management of ... regulations, government billing requirements, collection laws and reimbursement procedures. As the Senior Project Analyst, your role will be to build and implement… more
- Genesis Healthcare (Moline, IL)
- …to improving health outcomes among residents of skilled nursing and senior living facilities. Our physicians, nurse practitioners (NPs) and physician assistants ... Help articulate the AlignMed Partners mission to the community and professional organizations Help the center establish appropriate relationships, and coordinate… more
- Genesis Healthcare (Kennebunk, ME)
- …to improving health outcomes among residents of skilled nursing and senior living facilities. Our physicians, nurse practitioners (NPs) and physician assistants ... improve quality measures related to psychiatric care. 1. Demonstrates continued professional competence 2. Recognizes the importance of continued learning through:… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …**Job Description** **About the role:** As Counsel, Market Access, at the senior director level, you will be responsible for providing day-to-day legal support ... committees. + Preparing, reviewing, and negotiating complex government, payer, pharmacy and distributor agreements, including agreements with: commercial and… more
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