- CenterLight Health System (NY)
- …Data Analytics is responsible to lead the end-to-end accurate and timely claims payment processes, including managing TPA's performance, ensuring the integrity ... along with strong organizational and analytical skills. JOB RESPONSIBILITIES: Claims payment integrity: + Lead and deliver...Address any issues that raised and escalate as appropriate. Claims delegation and operations: + Manage day-today… more
- Molina Healthcare (CA)
- … (VBP) contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight. * In conjunction with Director , Provider Contracts, ... local regulations. Responsible for contracting/re-contracting of Complex contracts with Alternative Payment Methods including but not limited to Value Based and… more
- Hatch (Houston, TX)
- …of expenditure on the project (subject to agreed delegation ), and approves payment of invoices, manages claims responses and settlement processes. + Develops ... and the client for the project. Reports to: Regional Director , Project Management & Construction Delivery Key Responsibilities +...backup, to ensure efficient process by the client for payment of the works executed by Hatch. + Ensures… more
- Molina Healthcare (Long Beach, CA)
- …between Molina Healthcare and contracted provider network. In partnership with Director , manages and coordinates the Provider Services activities for the state ... outreach and resolving provider inquiries. * In conjunction with the Director , Provider Network Management & Operations, develops health plan-specific provider… more
- Point32Health (Canton, MA)
- …are approved by senior leadership, the Senior Manager, in collaboration with the Director , is responsible for all necessary product filings with CMS and other ... requirements and timelines. The Senior Manager works closely with claims , membership operations, clinical services, care management, customer relations, sales,… more
- Freeport-McMoRan (Phoenix, AZ)
- …appropriate actions in order to reduce Company's liability. + Support the Director of Contracts Management to establish and develop strategies to achieve the ... proper contract administration though control of the back charges, claims , correspondence, weekly meetings, proper documentation and other critical activities… more