- CVS Health (AZ)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... for: Performing pharmacy review and making evidence-based recommendations regarding Medicare members. Identify opportunities within the health plan for integration… more
- Datavant (Phoenix, AZ)
- Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the ... our bold vision for healthcare. As an **Inpatient Auditing Specialist ** you will be instrumental in addressing consulting and...be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care. Interest in… more
- Sumitomo Pharma (Phoenix, AZ)
- Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the US (Sumitomo Pharma America, Inc.), focused on addressing patient ... dynamic, highly motivated individual for the position of **Multi-Specialty Portfolio Specialist /Associate Portfolio Specialist .** This position is being posted… more
- Highmark Health (Phoenix, AZ)
- ** Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted ... government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using...(CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health Information Technician (RHIT) **Preferred**… more
- Cognizant (Phoenix, AZ)
- **Facets Dental Configuration Specialist ** **Location: Remote** **Employment Type: Full-Time** **Job ID: 67014021** **About the role** As a Technical Analyst - ... decisions and downstream impacts. + **Apply comprehensive knowledge of Medicaid, Medicare , and commercial business rules across configuration activities** . +… more
- CenterWell (Phoenix, AZ)
- …shifts twice a month.** + **Available to work 3 holidays a year.** The E-Referral Specialist is an integral part of the referral process as this role is the initial ... and adhere to all regulatory compliance areas, policies and procedures and company best practices. **Use your skills to make an impact** **Required… more
- Modernizing Medicine (Phoenix, AZ)
- …and a robust remote workforce across the US, Chile, and Germany. ModMed (https://www.modmed.com/ company /) is hiring a driven Patient Claim Specialist who will ... outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling (https://www.modmed.com/ company /leadership/) , we have grown to over 3400 combined direct and… more
- Mayo Clinic (Phoenix, AZ)
- …Competitive retirement package to secure your future. **Responsibilities** The HME Specialist I position is the first of multiple career opportunities within ... service. Must be able to work independently as needed. Knowledge of Medicare , Medicaid and/or private insurance billed preferred with attention to detail. Physical… more
- Molina Healthcare (Phoenix, AZ)
- …set-up and a resource for all departments and health plans company -wide. **Knowledge/Skills/Abilities** + Conduct interviews with staff and management to assess ... Experience with troubleshooting and analyzing issues. + Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly… more
- Highmark Health (Phoenix, AZ)
- ** Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is directly responsible for the value creation, impact and cost control, and fiscal/ROI ... strategies, Medication Therapy Management, utilization management, immunizations, specialty pharmacy, Medicare Stars, and Medicaid HEDIS to strategies designed to… more