Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Broward Health, ...

Improving member experience remains a top priority for payers — and for Medicare Advantage plans, it’s not just a goal but a business imperative. Member experience directly influences CMS Star Ratings ...

The Cigna Group’s Evernorth division introduced a rebate-free pharmacy benefit model that it says will lower medication costs and simplify drug pricing. The model removes the traditional post-purchase ...

Today, the durable medical equipment management (DME) process can be fragmented, inefficient, and unreliable – leading to errors and delays that impact member health, inflate costs for health plans, ...

Blue Cross Blue Shield of Massachusetts is expanding its claims review process to address what it is describing as potential overcoding among physicians who routinely bill for high-complexity visits.

CMS Administrator Mehmet Oz, MD, told FOX 5 Atlanta that the government shutdown is not affecting Medicare open enrollment. “The shutdown is a problem for lots of parts of government but not for ...

Elevance Health is deepening its use of artificial intelligence enterprise-wide, focusing on enhancements to its member services, clinical workflows and provider operations as part of long-term ...

Elevance Health has shared plans to potentially penalize hospitals and other contracted facilities that use care providers who are not in-network with its Anthem Blue Cross Blue Shield commercial ...

Elevance Health is working to mitigate rising costs in its Medicaid business amid what executives describe as a challenging year ahead. The company reported its third-quarter earnings on Oct. 21, with ...

Oklahoma Attorney General Gentner Drummond challenged the state’s managed care Medicaid in an Oct. 22 letter to the Oklahoma Health Care Authority, the agency that oversees the program. Mr. Drummond ...

The high cost of GLP-1 drugs have thrown a curveball at payer strategy. Employers providing health insurance are also grappling with the fallout. From January to July, Davis Research interviewed ...

Johnson City, Tenn.-based Ballad Health is suing UnitedHealth Group for alleged “Medicare Advantage manipulation” that has led to denied care and underpayment for services. The lawsuit was filed Oct.