• Provider Reimbursement Policy

    AmeriHealth Caritas (Philadelphia, PA)
    …+ At least 2 years' experience in a managed care organization setting in a provider reimbursement policy or provider network operations function ... among medical coders functioning in various roles + Mentors/trains Medial Policy Specialist . **Education/Experience:** + Associate's Degree preferred but not… more
    AmeriHealth Caritas (04/15/25)
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  • Provider Contracting Specialist

    CareFirst (Baltimore, MD)
    …Facilitate and manage the implementation process of the negotiated terms with the Reimbursement Implementation department as well as the Provider Information and ... Skills and Abilities (KSAs)** + Deep understanding of multiple reimbursement methodologies used in healthcare provider contracting....is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal… more
    CareFirst (04/18/25)
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  • Provider Account Specialist - SHP…

    Sharp HealthCare (San Diego, CA)
    …plan policies and procedures.Develops a communication plan for distribution of Plan policy changes and ensures that inventory of provider communication materials ... the Plan, by establishing and maintaining positive working relationships through provider engagement and management. Develops and presents provider more
    Sharp HealthCare (04/12/25)
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  • Provider Transformation Specialist

    Highmark Health (Albany, NY)
    …responsible for collaborative work with the other members of the value-based reimbursement team, provider relations, senior markets, analytics, actuary and key ... internal/external stake holders to provide the most appropriate support for providers with gain/risk share contracts. **ESSENTIAL RESPONSIBILITIES** + Directly… more
    Highmark Health (02/18/25)
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  • Network Management Specialist - SCMG…

    Sharp HealthCare (San Diego, CA)
    …Sharp HealthCare and all departments within SCMG. Specifically, recruit, orient and provide ongoing service to providers and ensure provider adherence to ... coordinates projects with other persons within the Network Management Department to provide education and communicate information to the provider network. (ie… more
    Sharp HealthCare (03/09/25)
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  • Network Reimbursement Specialist

    Independent Health (Buffalo, NY)
    …culture that fosters growth, innovation and collaboration. **Overview** The Network Reimbursement Specialist -Associate will ensure that all policies and ... a high degree of accuracy in workflows. The Network Reimbursement Specialist -Associate will have an understanding of...request process. + Assist in updating the corporate Participating Provider Reimbursement Manual. + Assist in the… more
    Independent Health (04/02/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Cheyenne, WY)
    …Lead or support key strategic initiatives across Enterprise and Markets and Provider Transformation for the Organization's value-based reimbursement programs and ... DE) and Enterprise Quality, Safety, and Values (Health Outcomes Measures). Provide actionable opportunities in provider transformation aimed at high-quality,… more
    Highmark Health (04/17/25)
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  • Reimbursement Support Specialist

    Sanofi Group (Cambridge, MA)
    **Job Title:** Reimbursement Support Specialist **Location** : Remote **About the Job** The Reimbursement Support Specialist (RSS) will support and work ... requires a high level of organization and strong communication skills. The Reimbursement Support Specialist follows standardized workflows as defined by… more
    Sanofi Group (04/11/25)
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  • Reimbursement Specialist

    Humana (Miramar, FL)
    …**Position Type** : Hybrid **Branch Location** : Miramar, FL The ** Reimbursement Specialist ** performs research, analysis, documentation, and interpretation for ... the provider reimbursement programs for an organization that...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (04/18/25)
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  • Epic Reimbursement Contract…

    Bozeman Health (Bozeman, MT)
    …states above to be applicable for this position. Position Summary: The Epic Reimbursement Contract Specialist is responsible for building and maintaining the HB ... policy , and other registry requirements. + Design, build, analyze, test, and provide support for Epic's Reimbursement Contracts + Serve as the subject matter… more
    Bozeman Health (01/30/25)
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