- Molina Healthcare (Columbus, GA)
- …+ Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon… more
- BrightSpring Health Services (Horsham, PA)
- …solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing ... PharMerica Overview Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals,… more
- BrightSpring Health Services (Union City, CA)
- …solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing ... Desired: Prior supervisory experience. Skills/Knowledge: + Required: Knowledge of Medicaid claims regulations and processes. Basic understanding of drugs, medication… more
- State of Minnesota (St. Paul, MN)
- …problem resolution skills in order to manage the investigation and resolution of Medicaid provider cases. + Experience establishing a Risk and Mitigation Plan. ... **Working Title: Quality Management Lead ** **Job Class: Human Services Program Consultant** **Agency: Human Services Dept** + **Job ID** : 90356 +… more
- Molina Healthcare (Naperville, IL)
- JOB DESCRIPTION Job Summary Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, ... utilization management, care transitions, long-term services and supports (LTSS), behavioral health, and other clinical programs, and collaborates with… more
- Chiesi (Boston, MA)
- …the status quo for the better. Who we are looking for Purpose As the Lead , Trade and Channel Strategy, you will act as a thought-leader and trusted advisor on ... and contractual customer relationships, as well as with Legal, Finance, Customer Service and members of Pricing and Contracts on daily responsibilities. This… more
- Fairview Health Services (Minneapolis, MN)
- …**Job Expectations:** **Enrollment Management** + Advanced working knowledge of Medicare, Medicaid , and third-party insurance/ payor plans. + Lead internal ... operation activities. **Organization Expectations, as applicable:** + Demonstrates ability to provide care or service adjusting approaches to reflect… more
- Humana (Frankfort, KY)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... us put health first** The DSNP Encounters Data Management Lead supports the Encounter Data Management team within the...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- CVS Health (Springfield, IL)
- …across service operations and medical management, including Claims, Encounters, Provider Services , Data Management, IT, Member Services , Network, ... oversees strategic and operational activities across key functional areas such as Claims, Provider Services , IT, Grievance & Appeals, Member Services , and… more
- CenterWell (Anderson, SC)
- …consumer experiences **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of ... age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our full accessibility rights… more