- Trinity Health (Syracuse, NY)
- …position Monday - Friday, Day Shift Schedule **Position: Clinical Risk Management Analyst ** **Mission Statement:** We, St Joseph's Health and Trinity Health, serve ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more
- Prime Therapeutics (Santa Fe, NM)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- WellSpan Health (York, PA)
- …requirements for qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount ... for qualified patients, drugs, and locations. - Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. -… more
- Molina Healthcare (Macon, GA)
- …prioritize work to meet deadlines and needs of user community. + GA Medicaid claims / reimbursement/ coding experience is highly preferred **JOB QUALIFICATIONS** ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Molina Healthcare (GA)
- …implementation and conversion of new and existing health plans. + GA Medicaid claims / reimbursement/ coding experience is highly preferred **JOB QUALIFICATIONS** ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Molina Healthcare (New York, NY)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- UTMB Health (Galveston, TX)
- Analyst , 340B Program - Contract Pharmacy **Galveston, Texas, United States** Allied Health UTMB Health Requisition # 2504846 **_REQUIRED EDUCATION / EXPERIENCE:_** ... and eligible patient status. + Monitors and audits state Medicaid prescriptions to ensure compliance to prevent potential duplicate...+ Partners with IS and RCO departments to ensure claims are going out with the correct modifiers and… more
- Bozeman Health (Bozeman, MT)
- Position Summary: The Credit Balance Analyst is responsible for processing refunds for third party insurance, Medicare, Medicaid , and Government-Assisted ... of all insurance and/or Government rules regarding payment, credit procedures, claims submittal and appeal process. Candidate must have excellent written and… more
- UnityPoint Health (Moline, IL)
- …assesses patients' financial and insurance information in order to determine Medicaid , Marketplace, or other Community Programs or Resources. Why UnityPoint Health? ... and others for high deductible, out-of-pocket expenses, unresolved or pending claims , out-of-network procedures and other financial risk issues + Counsels patients… more
- Amentum (Baltimore, MD)
- …of information. + Familiarity with specific subject matter helpful. + Medicare and Medicaid claims , student loan programs, DoD contracting, etc. + Excellent oral ... federal, state, and local officials, and other organizations, including Medicare and Medicaid contractors, related to the subject of the investigation for the… more