- Molina Healthcare (Owensboro, KY)
- …accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST will require to work 1 ... detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of… more
- Molina Healthcare (Bowling Green, KY)
- …accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for the comprehensive ... and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response. * Meets claims production standards set… more
- Prime Therapeutics (Frankfort, KY)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...outbound calls to qualified members across all lines of business to review the benefits of the MTM program.… more
- Novo Nordisk (London, KY)
- …promoting Novo Nordisk's portfolio of products to HCPs and other office staff. Relationships Externally, the CMCS Imaintains relationships with physicians, physician ... and current co-promotion partners. Internally, the CMCS I reports to the District Business Manager of the specific sales territory. The CMCS I also interacts and… more
- Molina Healthcare (KY)
- …with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... and cost-effective member care. This position will support our Corporate Compliance business . The candidate must have an unrestricted LVN licensure. Candidates must… more
- Humana (Frankfort, KY)
- …well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, including ... residency or similar pharmacy practice experience + Board Certified Pharmacotherapy Specialist (BCPS) + MBA, pharmacoeconomics or health outcomes training + An… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** The role of the Print and Financial Services Specialist Project Manager is to plan, execute, and finalize project tasks associated with ... with the Patient Tools. The Print and Financial Services Specialist is responsible for coordinating the efforts of project...of project estimated revenue prior to transition of the business account. **WHAT YOU'LL DO** + Ability to comprehend… more
- Evolent (Frankfort, KY)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the… more
- Molina Healthcare (Owensboro, KY)
- …improvement, organizational change management, program management and other processes relative to business needs. * Serves as a subject matter expert and leads ... quality initiatives within the department as appropriate. * Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs),… more