- CommonSpirit Health (Phoenix, AZ)
- **Responsibilities** **Position Summary:** The Senior Reimbursement Analyst is responsible for providing cost report preparation cost report appeals ... to the Reimbursement Managers and/or Directors. Accountabilities: Prepares interim and annual cost reports for Medicare Medicaid and other State or Federal… more
- CommonSpirit Health (Phoenix, AZ)
- **Responsibilities** The **Senior Reimbursement Analyst i** s responsible for providing cost report preparation, cost report appeals, audit preparation ... Managers and/or Directors. Accountabilities: 1. Prepares interim and annual cost reports for Medicare , Medicaid and other...five (5) years of experience with all aspects of Medicare and Medicaid (Medi-Cal) regulations monitoring and report… more
- Humana (Phoenix, AZ)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...are involved in Board and other administrative meetings. Fellows report directly to Joel Port, SVP, Business and Network… more
- CVS Health (Phoenix, AZ)
- … Medicare Fast Track Appeal requests. Identify trends and emerging issues and report and recommend solutions. Research incoming Medicare Fast Track appeals to ... Summary** Responsible for managing to resolution of Fast Track Appeals for Medicare products, which may contain multiple issues and, may require coordination of… more
- Molina Healthcare (Chandler, AZ)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care. + Ensures that medical decisions are rendered… more
- CVS Health (Scottsdale, AZ)
- …closely with multiple internal departments such as Sales, Account Management, IT, Medicare Part D Services, Client Audit, Benefits, and Implementations to manage and ... - PBM Industry and plan design. - RxClaim adjudication or benefits knowledge. - Medicare Part D - PBM or claim adjudication knowledge. - Proficiency in IBM AS400.… more
- CenterWell (Phoenix, AZ)
- …evaluating and operationalizing high-impact complex care initiatives to drive quality and cost improvement for high-risk senior populations in full risk Medicare ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- Dignity Health (Phoenix, AZ)
- …for the clinical teams within Arizona Care Network (ACN). ACN CPLs report to the Manager of Practice Transformation within the Clinical Performance Department, ... performance in value based contracts (CMS ACO, HEDIS, NCQA, etc.) and Medicare Advantage programs (HCC/RAF). In addition these positions also support our clinicians… more
- Humana (Phoenix, AZ)
- …Associate Actuary, Medicaid Trend focuses on developing, monitoring, and communicating cost trend drivers, utilization patterns, and economic insights to support ... you will play a critical role in identifying, quantifying, and explaining healthcare cost and utilization trends. The Associate Actuary works together with a team of… more
- Tucson Electric Power (Tucson, AZ)
- …bodies and assists in the execution thereof (eg, ACA reporting, Medicare Notice of Creditable Coverage, PCORI fees, conducting monthly pension reconciliation ... special studies regarding employee benefits design to determine the cost -effectiveness of existing programs, evaluate alternatives and assess the desirability… more
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