- Prime Therapeutics (Phoenix, AZ)
- …resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments within project + Educate and advance ... Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid, the Exchanges along with regulatory compliance requirements (HIPAA… more
- Humana (Phoenix, AZ)
- …information to the application at Humana's secure website. + Position reports to Manager , Technology Solutions, IT HPE - Digital Channels & Contact Centers + ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Banner Health (Scottsdale, AZ)
- …and challenges), an in-office team of QI specialists, telehealth resources, clinical manager and in office triage support. This structure is designed to assist ... measures better than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. POSITION SUMMARY This position assesses,… more
- CenterWell (Cottonwood, AZ)
- …the HHA Registry (if applicable) and have completed HHA/CNA course to work for a Medicare certified agency. + At least one year experience in the last 24 months as ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- CVS Health (Phoenix, AZ)
- …appeal activity as well as preparing for appeals audits. + Consults with manager on complex cases and interfaces with case managers, clinical supervisors, and other ... regulations are addressed. **Required Qualifications** + 1-2 years of experience in Medicare , AHCCCS, and the healthcare industry + Strong reading and writing skills… more
- CenterWell (Phoenix, AZ)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + Previous clinical experience in managed care ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- Humana (Phoenix, AZ)
- …largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical, ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Elevance Health (AZ)
- …authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Sanofi Group (Phoenix, AZ)
- …management experience or healthcare experience + 5-10 years of prior field reimbursement manager experience + 3 years or more of team lead or supervisory experience ... and strong understanding of health insurance and benefits, co-pay assistance programs, Medicare , Medicaid, and private payer policies + Strong listening, verbal, and… more
- Molina Healthcare (Chandler, AZ)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in Healthcare… more
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