- Molina Healthcare (Houston, TX)
- …ancillary providers with Medicaid and/or Medicare products * 5+ years previous managed healthcare experience. * Previous experience with community agencies and ... providers. * Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or… more
- Staffing Solutions Organization (Albany, NY)
- …Back Office (NYSOH) + Experience in investigating issues in enrollment and eligibility and Managed Care Plan regulatory compliance + Knowledge of medical ... LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed...reflection of our clients and the people they serve. ** Healthcare Data Specialist 1 - Albany, NY** **Division of… more
- Molina Healthcare (Cincinnati, OH)
- …in resolving complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional ... trends, payment integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- NTT America, Inc. (Philadelphia, PA)
- …services, and industry vertical solutions to include things like regulatory compliance solutions, digital solutions, mobile solutions, transformational ... DATA is seeking has 12+ years of **IT Sales** experience in the ** Managed Services/Professional Services** space and strong relationships in the ** Healthcare … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …the organization + Manages section resources in line with budget + Ensures compliance with policies, procedures and regulatory guidelines + Handles operational ... **Overview** **Be inspired. Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel...of patient care, efficient use of clinical resources, and compliance with managed care contractual obligations +… more
- Centene Corporation (Jefferson City, MO)
- …ethics and compliance program, and ongoing oversight and analysis of regulatory compliance practices. + Collaborates with internal teams and external vendors ... regulations preferred. + 2+ years State Medicaid or government sponsored healthcare compliance . preferred. **Licenses/Certifications:** HealthCare … more
- Bassett Healthcare (Cooperstown, NY)
- …in accordance with standard operating procedure to support reimbursement and regulatory compliance and patient care. When Appropriate prior authorizations ... first point of contact for patients within the Bassett Healthcare Network. This is a key role in the...capture and data entry (such as MSPQ) necessary for regulatory agencies and compliance requirements is accurate… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …+ Collaborate across departments to ensure alignment on improvement strategies and goals. Regulatory Compliance & Governance + Ensure reporting accuracy and ... The analyst ensures data accuracy, provides actionable insights, and supports compliance with regulatory and value-based care programs. Compensation: $32.46… more
- Humana (Dublin, OH)
- … Repository_ + _Coordinate and compose time sensitive responses to incoming regulatory inquiries and issues reflective of compliance with program requirements_ ... of our caring community and help us put health first** The Senior Compliance Professional ensures compliance with governmental requirements. The Senior … more
- Molina Healthcare (Akron, OH)
- …environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ... group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and… more
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