• Audit & Reimbursement Senior

    Elevance Health (Nashville, TN)
    … and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with ... Reimbursement Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement . This position provides a… more
    Elevance Health (08/26/25)
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  • Dir Net Revenue & Reimb

    Covenant Health Inc. (Knoxville, TN)
    …Revenue & Reimbursement is responsible for leading Covenant Health's reimbursement strategy across all payors, including Medicare , Medicaid/TennCare, and ... operations and financial performance. Recruiter: Suzie Mcguinn || ###@covhlth.com Responsibilities Medicare & Medicaid Reimbursement Oversight + Lead all phases… more
    Covenant Health Inc. (08/28/25)
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  • Executive Director Specialist RN

    Gentiva (Nashville, TN)
    …sales/management experience, preferably in hospice or healthcare + Experience with Medicaid/ Medicare regulations and reimbursement + Strong understanding of ... performance improvement + Drive clinical quality and ensure services meet Medicare Conditions of Participation, state hospice regulations, and Gentiva standards +… more
    Gentiva (08/25/25)
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  • Medical Director - Medicare Appeals

    CVS Health (Nashville, TN)
    …participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The ... Medical Director will act as a business and clinical liaison to network providers and facilities if needed, to support the effective execution of medical services programs by the clinical teams. **Required Qualifications** *Two (2) or more years of experience… more
    CVS Health (08/08/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (TN)
    …Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group ... clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work… more
    Banner Health (08/30/25)
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  • Hospice Care Consultant

    AccentCare, Inc. (Franklin, TN)
    …Skilled in problem-solving, understanding referral patterns, and navigating or learning Medicare regulations and hospice reimbursement practices. Proficient with ... Microsoft Office Suite; available for after-hours and weekend referrals as needed. Physically capable of frequent standing, walking, typing, and working on hard/rough surfaces; occasional lifting, kneeling, reaching, and exposure to chemicals, dust, extreme… more
    AccentCare, Inc. (07/30/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Knoxville, TN)
    …relates to payer approval processes and business acumen. + Understanding of Medicare , Medicaid, and private payer initiatives affecting reimbursement of ... at https://www.jnj.com **Job Function:** Market Access **Job Sub** **Function:** Reimbursement **Job Category:** People Leader **All Job Posting Locations:**… more
    J&J Family of Companies (08/25/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Nashville, TN)
    …teams that engage providers enrolled in the Organization's value-based reimbursement programs and continuous improvement models. The incumbent plays different ... of workflows resulting in outstanding performance in the Organization's value-based reimbursement programs ensuring that ROI targets as set by the Organization… more
    Highmark Health (08/20/25)
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  • Reimbursement Manager

    HCA Healthcare (Brentwood, TN)
    …like you to be a part of our team. **Job Summary and Qualifications** As Reimbursement Manager, you will complete Medicare and Medicaid cost reports to obtain ... join an organization that invests in you as a Reimbursement Manager? At HCA Healthcare, you come first. HCA...policies and procedures. Your responsibilities will include: + Prepare Medicare and Medicaid cost reports to obtain all amounts… more
    HCA Healthcare (06/21/25)
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  • Field Reimbursement Manager

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert on reimbursement , access, and coverage issues for our products, ... Educate HCPs and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria… more
    Otsuka America Pharmaceutical Inc. (08/27/25)
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