• Senior Specialist , Provider Network…

    Molina Healthcare (Tucson, AZ)
    …+ Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (eg, ... Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with… more
    Molina Healthcare (08/02/25)
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  • Intake Specialist (Complaint & Appeals)

    CVS Health (Phoenix, AZ)
    …reasons for calling is thorough and precise. + Provide empathetic and compassionate support to all callers. + Assist with special projects as assigned. **Required ... Qualifications** + Must reside in Arizona. + 6 months+ of working with Medicare and Medicaid programs. + 6 months+ of behavioral health systems experience related to… 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...Health System. Humana takes the lead in providing administrative support in various areas including HR. DVACO's MSSP participation… more
    Humana (07/30/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Phoenix, AZ)
    **Job Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan ... 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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  • Nurse Practitioner or Physician Assistant…

    CenterWell (Sun City, AZ)
    …the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their ... advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows… more
    CenterWell (08/28/25)
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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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  • Executive Director, Chief Actuary

    Banner Health (Phoenix, AZ)
    …strategy, identifying strategies to reduce enterprise costs, reviewing reserves in support of audits of health care liabilities, communicating ROI for medical ... preparing and delivering reports and presentations, analyzing, developing, and/or submitting Medicare Advantage and Prescription Drug plan bid pricing tools and/or… more
    Banner Health (08/23/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (AZ)
    …for anywhere from 1 - 3 months according to individual needs, with continued support throughout your career here! This is a fully remote position and available if ... have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding… more
    Banner Health (08/30/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Phoenix, AZ)
    …thought partner to health plan leadership and provide well-reasoned recommendations that support short- and long-term business goals. + Partner with Network to ... + Partner with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets. **Applied Analytical … more
    Molina Healthcare (08/14/25)
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  • Senior Coding Data Quality Auditor, Coding Quality…

    CVS Health (Phoenix, AZ)
    …day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a critical part in ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of...and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence… more
    CVS Health (08/24/25)
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