• 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 ... codes, etc. + Access and Excel - intermediate skill level (or higher) ** Preferred Education** Bachelor's Degree ** Preferred Experience** + 5+ years managed care… more
    Molina Healthcare (08/02/25)
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  • Sr Specialist , Credentialing, Network…

    Cardinal Health (Phoenix, AZ)
    …scheduled training. **_Qualifications_** + Bachelors degree or equivalent experience in Managed Care preferred + 2-4 years experience in health care preferred + ... Pharmacy Technician experience a plus, not required + Familiarity with Medicare and Medicaid + Proficient in Microsoft Office (Excel VLOOKUPS) + Strong written and… more
    Cardinal Health (07/24/25)
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  • Intake Specialist (Complaint & Appeals)

    CVS Health (Phoenix, AZ)
    …Qualifications** + Must reside in Arizona. + 6 months+ of working with Medicare and Medicaid programs. + 6 months+ of behavioral health systems experience related ... the information provided by callers to ensure completeness and accuracy. ** Preferred Qualifications** + Excellent communication skills. + Strong critical thinking… more
    CVS Health (08/22/25)
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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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  • Senior Systems Engineer - IAM

    Ensono (Phoenix, AZ)
    …US Citizenship and pass related background checks including but not limited to Medicare and Medicaid and VA ** Preferred Skills:** + Experience with secure ... policies, regulatory requirements, and industry best practices. The IAM Specialist will also be responsible for maintaining all necessary certifications… more
    Ensono (08/07/25)
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  • Market CMO, Centerwell Senior Primary Care…

    CenterWell (Phoenix, AZ)
    …Provider Number + Minimum of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with ... + Oversee daily operations of physician services. + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of… more
    CenterWell (07/25/25)
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  • Senior Coding Data Quality Auditor, Regulatory…

    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 (08/21/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Phoenix, AZ)
    …and verbal communication skills including ability to synthesize complex information. ** PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
    Molina Healthcare (08/20/25)
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  • Payment Integrity Program Manager - Health Plan

    Molina Healthcare (Mesa, AZ)
    …and verbal communication skills including ability to synthesize complex information. ** PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and ... achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for… more
    Molina Healthcare (08/14/25)
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  • Health Plan Operations, Payment Integrity Program…

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