- Molina Healthcare (NM)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Molina Healthcare (Rio Rancho, NM)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for ... certain assets within the broader CNS TA portfolio Medical Affairs (both US and Global), with a specialization...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Position Summary** : Reporting to the Vice President, Global Medical Affairs, the Executive Director, CNS Strategy, Global Medical Affairs is a leadership ... position responsible for the strategic and tactical medical plans of both global and US ...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Sedgwick (Santa Fe, NM)
- …and industry best practices. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Adjusts medical -only claims and low- to mid-level lost-time workers compensation ... not limited to claimant, client, state agency, managed care organization and appropriate medical contact. + Ensures claims files are properly documented, and … more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Job Summary** Otsuka is looking for a strong Clinical Statistician in the Medical and Real World Data Analytics organization to provide statistical expertise for ... internal data scientists and data programmers, and external stakeholders including Medical Affairs, Value and Real World Evidence to provide end-to-end statistical… more
- Humana (Santa Fe, NM)
- …2 opening available. The Payment Integrity Professional 2 utilizes vendor platforms, claims processing platforms, and data to collaborate with key internal ... (CAPI) _formerly Claims Cost Management (CCM)_ + Prior experience analyzing medical claims data **Additional Information** **Work at Home Requirements** * At… more
- Norstella (Santa Fe, NM)
- Sr. Medical Analyst Company: MMIT Location: Remote, United States Date Posted: Sep 3, 2025 Employment Type: Full Time Job ID: R-1370 **Description** **Why ... to market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role,… more
- Molina Healthcare (Las Cruces, NM)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including… more
- Cardinal Health (Santa Fe, NM)
- …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more