- CVS Health (Providence, RI)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... each and every day. **Position Summary** The Specialty Strategic Account Executive - Payer Relations manages a portfolio of small to mid-size regional health plan… more
- Sharecare (Charleston, WV)
- …visit www.sharecare.com . **Job Summary:** CareLinx is looking for a Care Advisor to assist with CareLinx's Payer Operations line of business. CareLinx is ... hire process. Once a caregiver match is made, the Care Advisor will follow closely to ensure...be the place for you. **Location:** This role is remote , except for candidates located in the Mesa, AZ… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... referred by case management staff and/or other health care professionals to meet regulatory requirements and in accordance with the system's objectives for assuring… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **This is a remote position.** **This position represents 1 of 2 available opportunities.** We are seeking a highly skilled ... across all levels (1-5), including IRO and ALJ reviews, utilizing payer -specific tracking tools. The successful candidate will also collaborate cross-functionally… more
- CommonSpirit Health Mountain Region (Salt Lake City, UT)
- …roles, preferred. + Experience as a Physician Advisor in the acute care setting and/or the payer environment, preferred. + Education and experience in ... and Kansas, we deliver the same high standard of care to our employees as we do to our...position is a hybrid role requiring a mix of remote and on-site work at the five CommonSpirit Hospitals… more
- The Cigna Group (Bloomfield, CT)
- **Work Location: Remote - Work at Home** The **Competitive Unit Cost Advisor ** will focus on the analysis of competitive unit cost information, validation of ... COB, MCR/State Cost Data, UC Plan, Hospital Transparency Analytics, Payer Transparency Analytics, NS&E updates, Local Market Affordability reviews, Market/Provider… more
- Lilly (Indianapolis, IN)
- …and Value Proposition that addresses key customer needs (patient, provider, and payer ); the product lifecycle plan, clinical strategies, development plans and study ... with respect to data dissemination and interactions with external health care professionals. + Understand and address the unsolicited scientific information needs… more
- Virtua Health (Pennsauken, NJ)
- …the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing ... care , or something in-between - we are your partner...for pediatrics. Location: Pennsauken - 6991 North Park Dr. Remote Type: 100% Remote Employment Type: Employee… more
- HonorHealth (AZ)
- …utilization of available resources. Performs medical record reviews, as required by payer . Interfaces with Care Management team to provide information regarding ... you'll be part of a team, creating a multi-dimensional care experience for our patients. You'll have opportunities to...conducts follow-up reviews, and escalates secondary reviews to Physician Advisor as necessary. + Maintains a system to identify… more
- Nuvance Health (Danbury, CT)
- *Description* *FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED* * *Hybrid/ Remote * * *Summary:* The purpose of the Denial Prevention Nurse is to ... will require specialized system skills, best practice application of investigating payer practices, successfully challenging payers as they prevent obstacles and… more