- Intermountain Health (Phoenix, AZ)
- …reviewed, and reconciled. Reviews or prepares monthly Medicare and Medicaid contractual allowance calculations using technically acceptable and reasonably ... allowance and variance calculations. Works closely with the appropriate Budget Manager, Finance Director, and Chief Financial Officer to ensure that the computed… more
- Humana (Phoenix, AZ)
- …own and evolve our enterprise-wide Anaplan platform across both Workforce Planning ( Finance ) and Workforce Management (HR) domains. This role requires a rare blend ... of functional and technical expertise, deep understanding of Finance and HR business processes, and the ability to...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Phoenix, AZ)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... data, and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looks for long term improvements of encounter submission processes. Begins to… more
- Molina Healthcare (Chandler, AZ)
- …responsible for overseeing all aspects of healthcare subrogation operations across Medicaid , Medicare, and Marketplace lines of business. This includes direct ... protocols to support efficient and compliant subrogation operations across Medicaid , Medicare, and Marketplace populations. + Collaborate with legal, claims,… more
- Prime Therapeutics (Phoenix, AZ)
- …business (Employer Markets, Health Insurance Marketplace (HIM), Commercial, Medicare, and Medicaid ). This individual is the primary relationship and contract owner ... of business, and key departments such as clinical, trade, and finance . This position establishes and maintains relationships with client decision-makers, industry… more
- HonorHealth (AZ)
- …for overseeing and maximizing reimbursement from government payors, including state Medicaid (AHCCCS) Reimbursement Initiatives and CMS final rules. Compiles public ... data from Medicare and Medicaid websites to model reimbursement effect of programs. Analyzes data and makes recommendations to CFO on how to maximize reimbursement.… more
- Molina Healthcare (Scottsdale, AZ)
- …analysis across multiple states and lines of business (Medicare, Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing health care ... Advantage members, the HHS model for Commercial ACA members, the CDPS model for Medicaid members, and others as needed + Must have a strong attention to detail… more
- Molina Healthcare (Tucson, AZ)
- …Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and ... impact of provider reimbursement changes + Provide data driven analytics to Finance , Claims, Medical Management, Network, and other departments to enable critical… more
- Molina Healthcare (Scottsdale, AZ)
- …with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional ... Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract… more
- Prime Therapeutics (Phoenix, AZ)
- …the Chief Compliance Officer's reporting to the Corporate Compliance Committee (CCC) and Finance , Compliance & Audit Committee (FCA) meeting materials. + Act as a ... within a highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must...study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care Act knowledge and experience **Physical… more