• Senior Specialist , Provider Network…

    Molina Healthcare (Tucson, AZ)
    …Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other ... provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation. + Develops and maintains documentation and guidelines for all… more
    Molina Healthcare (08/02/25)
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  • Delaware Valley ACO Fellowship

    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...Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health… more
    Humana (07/30/25)
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  • Coder I - Inpatient

    HonorHealth (AZ)
    …at least one (1) of the following certifications: CCS (Certified Coding Specialist ), or CIC (Certified Inpatient Coder), or RHIT (Registered Health Information ... documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical… more
    HonorHealth (08/27/25)
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  • Coder II - Inpatient

    HonorHealth (AZ)
    …documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical ... documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical… more
    HonorHealth (07/16/25)
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  • Nurse Practitioner or Physician Assistant…

    CenterWell (Sun City, AZ)
    …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... for TB. **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare more
    CenterWell (08/28/25)
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  • Executive Director, Chief Actuary

    Banner Health (Phoenix, AZ)
    …preparing and delivering reports and presentations, analyzing, developing, and/or submitting Medicare Advantage and Prescription Drug plan bid pricing tools and/or ... leadership. Will direct the preparation of rate filings to Centers for Medicare and Medicaid Services (CMS), Health and Human Services (HHS), Arizona's Medicaid… more
    Banner Health (08/23/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Phoenix, AZ)
    …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience + Proven… more
    Molina Healthcare (08/20/25)
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  • Market CMO, Centerwell Senior Primary Care…

    CenterWell (Phoenix, AZ)
    …+ Oversee daily operations of physician services. + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of ... consumer experiences **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to… more
    CenterWell (07/25/25)
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  • Senior Coding Data Quality Auditor, Coding Quality…

    CVS Health (Phoenix, AZ)
    …applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. + Experience with International Classification of Disease (ICD)… more
    CVS Health (08/24/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Phoenix, AZ)
    …and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially ... ability to synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and Marketplace lines of business. + PMP, Certified… more
    Molina Healthcare (08/14/25)
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