- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Responsible for seeking contract opportunities, reviewing contract language and terms, conducting data analysis on financial terms, negotiating ... problem resolutions regarding payment issues with all contracted payors. Manages the contract review process for RCSSD 3rd party contracts, contracts with payors,… more
- CommonSpirit Health (Rancho Cordova, CA)
- …and have California physician contract experience. **Job Summary:** The Contract Specialist Divisional Payers Payer Strategy & Relationships (PSR) works ... to support the negotiation of terms and conditions for Managed Care payer contracts for facility professional...to ensure the terms and conditions of the payer contract adhere to the CSH Standards and Guidelines represent… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to ... their leadership. It is a requirement for the Reimbursement Specialist I to read, interpret and apply complex payor... I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all… more
- Sharp HealthCare (San Diego, CA)
- …in Healthcare Management, Business, or other degree acceptable with combination of education and managed care experience. + 3 Years experience in a managed ... apply knowledge as part of day-to-day job responsibilities. + Knowledge of managed care principles, reimbursement methodologies, and healthcare delivery systems.… more
- Prime Healthcare (Lynwood, CA)
- …, Account Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications + Minimum of four years hospital… more
- Sharp HealthCare (San Diego, CA)
- …requirements and quality standards are being monitored effectively.Maintain an understanding of basic managed care concepts and principles including Managed ... business practices. **What You Will Do** The Provider Relations Specialist is responsible for the development and maintenance of...or Equivalent + 4 Years experience in the health care field with particular emphasis on physician network, physician… more
- Emanate Health (Covina, CA)
- …preferred. Experience within an acute hospital setting, with strong emphasis on managed care contract and appeals/underpayment collection activities. ... at Emanate Health plays a vital role in the care we deliver. No matter what department you belong...Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations. Strong analytical skills, proficient with spreadsheets. c.… more
- Providence (Mission Hills, CA)
- …of experience in a Provider Relations role working with physicians in a Managed Care /IPA, Medical Group, Health Plan or MSO environment. **Preferred ... Bachelor's Degree in Healthcare Management or related field. + 5 years of Managed care Provider Relations experience. **Why Join Providence?** Our best-in-class… more
- Mass Markets (CA)
- …complete an easy online application and an informal interview with a talent acquisition specialist . If you do not have your equipment, MCI will provide it. You will ... applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition,… more