- Molina Healthcare (Mesa, AZ)
- …administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care ... services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports… more
- Molina Healthcare (Mesa, AZ)
- …oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School ... regulations pertaining to health insurance, investigations & legal processes (Commercial insurance, Medicare , Medicare Advantage, Medicare Part D, Medicaid,… more
- 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
- Humana (Phoenix, AZ)
- …approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, ... + PharmD + Health Plan experience + Knowledge of Medicare as it relates to pharmacy + Six Sigma...or similar pharmacy practice experience + Board Certified Pharmacotherapy Specialist (BCPS) + MBA, pharmacoeconomics or health outcomes training… more
- 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 (Phoenix, 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
- Banner Health (Mesa, AZ)
- …measures better than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. POSITION SUMMARY This position evaluates ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- Molina Healthcare (Scottsdale, AZ)
- …Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically ... appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access and interpret… more
- Molina Healthcare (Mesa, AZ)
- …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... delegated groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee for Quality… more
- CVS Health (Phoenix, AZ)
- …within budgeted costs. **What you will do** + Acts as a top-level specialist on project management and develops a comprehensive plan that encompasses objectives, ... Qualifications** + Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare -Medicaid Integrated Product Experience + Experience with Part… more