- e CancerCare (Nashville, TN)
- Job Purpose: Manager of Payor Contracting is responsible for reviewing, auditing and negotiating existing and new Payor contracts with Health Insurance ... etc). Reporting to the Director of Managed Care, the Manager of Contracting is responsible for managing...tracking of all various managed care payors. Advances company payor strategy and aligns negotiation with strategy. Essential Functions:… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is ... Coordinates communication and problem resolutions regarding payment issues with all contracted payors. Manages the contract review process for RCSSD 3rd party contracts, contracts with payors, IPA's, PPO's, ancillary providers and other vendors. Responsible… more
- Hackensack Meridian Health (Edison, NJ)
- …mission to transform healthcare and serve as a leader of positive change. The ** Manager of Revenue & Contracting Operations (MRCO)** is responsible for the ... for the accurate development, implementation, and maintenance of all payor and contractual logic builds within the EPIC contract...system. **Responsibilities** A day in the life of a ** Manager of Revenue & Contracting Operations (MRCO)**… more
- Guthrie (Sayre, PA)
- Position Summary: The Provider Enrollment Specialist reporting to the Payor Contracting & Provider Enrollment Manager plays an essential role in ensuring the ... and timely entry of provider data, resolving issues and barriers with payor credentialing teams. Proactive internal and external communication including but not… more
- Baptist Memorial (Memphis, TN)
- Summary Identifies, evaluates and negotiates contracting opportunities to grow the existing business, develop new business and expand provider network. In-depth ... understanding of health care and managed care contracting concepts, reimbursement, methodologies, and health benefit plan designs. Perceptive of general market… more
- Cleveland Clinic (Cleveland, OH)
- …business basics including, physician practice workflows, provider billing, risk coding, and payor contracting preferred. + Experience in quality and financial ... world. As part of the CCHS Value Based Performance team, the Program Manager will help support value based contracting , implementation, program management, and… more
- HCA Healthcare (Nashville, TN)
- … quality initiatives + Collaborates with interdisciplinary teams and leaders (PSG, Payer Contracting & Alignment, Quality and Payor Initiatives) to achieve the ... like family! Jump-start your career as an RN Care Manager WFH with HCA Capital Care Coordination today. **_...and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Assists in educating practice staff on… more
- HCA Healthcare (Nashville, TN)
- … quality initiatives + Collaborates with interdisciplinary teams and leaders (PSG, Payer Contracting & Alignment, Quality and Payor Initiatives) to achieve the ... 156,000 hours volunteering in our communities. As a Care Manager WFH with HCA Healthcare you can be a...and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Assists in educating practice staff on… more
- Philips (Malvern, PA)
- As a Reimbursement Services Manager , you will oversee and manage the daily operations of accounts receivable for all aspects of AM&D's revenue cycle, which includes ... process, as well implementing process improvements. **Your role:** + Identifying payor trends and making recommendations for increased revenue opportunities and… more
- Sutter Health (Berkeley, CA)
- **Organization:** ABSMC-Alta Bates Herrick Campus **Position Overview:** The Psychiatric Case Manager coordinates the care of patients through the provision of ... team, external case managers, referring therapists, outpatient clinic, and payor . Preferred experience includes: experience working with severely mentally ill… more
- Commonwealth Care Alliance (Boston, MA)
- …and Value Based Care,** the Provider and Facility Quality & Safety Manager is responsible for designing and executing quality measurement and improvement programs ... other CCA contracts, health equity, and social determinants of health (SDOH) measures.The Manager of Provider and Facility Quality and Safety to improve the care we… more
- Scripps Health (San Diego, CA)
- …third party payor billing problems. * Working with the Scripps contracting department and third party payors to resolve problems. * Participating in the ... and monitor CDM changes. Provides other support to the Manager Chargmaster as needed. CDM responsibilities include but are...Medi Cal California Workers Compensation and other third party payor bulletins to keep current on billing requirements. *… more
- Mindful Support Services (Mountlake Terrace, WA)
- About the Role: The Credentialing Manager is responsible for the day-to-day management of the Credentialing and Compliance department. The Credentialing Manager ... and project management skills to the department, and will support the Compliance Manager with projects and priorities. The Credentialing Manager will handle… more
- CVS Health (Blue Bell, PA)
- …more personal, convenient and affordable. Position Summary Serves as project manager and/or participant on selected project(s). Claim payment issues submitted ... our MEU QuickBase tool will be reviewed in the claims and provider contracting systems for payment accuracy and if needed creating overpayment projects. Provides… more
- Tidelands Health (Pawleys Island, SC)
- …supervisor of the Revenue Cycle Assistant Director, the Revenue Cycle Manager applies professional administrative knowledge and skill while providing accountable ... teleconferences, and training sessions. + Work closely with the Managed Care contracting department, monitor updates and train staff to comply with Managed Care… more
- Amgen (Kansas City, KS)
- …worldwide. It's time for a career you can be proud of. **Oncology Key Accounts Manager - Kansas** **Live** **What you will do** Let's do this. Let's change the ... (executive and administrative level personnel within assigned accounts) with respect to contracting , pricing and value messages in support of Amgen's full Oncology… more
- CDI (Roanoke, VA)
- …information systems * Provides input into sales, negotiations, and implementation of the payor contracting processes * Monitors payor referral activity (35%) ... segmentation plan, by product line, for defined territory * Partners with Sales Manager and Market Leader to execute strategic marketing and territory plans to… more
- Merck (Columbus, OH)
- …NAD works with internal personnel from the Customer Contract Management (finance), Contracting Capability Evolution (data & analytics) Payor Brand Marketing, ... the GPO, Network and 340B books of business. + Effectively managing the contracting process; collaborating with internal customer manager (s) and legal teams. +… more
- Fresenius Medical Center (Columbus, OH)
- …payors. + Partners with Division and Corporate functions regarding managed care and payor contracting . + Works with internal and external counsel to resolve ... of FMS, and financial management. Reports to the General Manager (GM) and may stand in for the GM...systems within the Group geography. + Oversees managed care contracting in collaboration with the Corporate Managed Care and… more
- The Cigna Group (Tucson, AZ)
- …strongly preferred. + 2+ years' experience in customer service, claims, and/or payor related experience + Demonstrated knowledge of contracting process, Medicare ... (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager , Director, and Other Administrators. Provider Performance Enablement (PPE) is responsible… more