• Member Appeal & Grievances Triage Admin…

    Fallon Health (Worcester, MA)
    …strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE ( Program of All-Inclusive Care ... decisions. + Ensure that all grievances/appeals are processed in adherence to state and federal regulations (ie, CMS, MassHealth, OPP), contractual obligations, NCQA… more
    Fallon Health (11/18/25)
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  • Pre-Authorization Specialist 1

    Rush University Medical Center (Chicago, IL)
    …clearance, accounting, or customer service. * Knowledge of insurance and governmental programs , regulations, and billing processes eg, Medicare, Medicaid , Social ... authorization to support insurance specific plan requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, ancillary… more
    Rush University Medical Center (10/22/25)
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  • Payer Relations Specialist

    Waystar (Atlanta, GA)
    …with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, mutually beneficial data exchanges that drive ... and understanding of the driving forces in the local, state , and national healthcare markets and the ability to...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
    Waystar (09/29/25)
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  • Support Staff Supervisor

    Fallon Health (Dartmouth, MA)
    …health and inspiring hope, we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an… more
    Fallon Health (12/17/25)
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  • Safety Quality Patient Experience Specialist II

    Cleveland Clinic (Mayfield Heights, OH)
    …in working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys ... and experience world-class healthcare at its best. Hillcrest Hospital provides state -of-the-art healthcare to all its patients. Cleveland Clinic is recognized as… more
    Cleveland Clinic (12/03/25)
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  • LPN - Per Diem

    Fallon Health (Lowell, MA)
    …health and inspiring hope, we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an… more
    Fallon Health (11/27/25)
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  • Physician Contracts Manager

    OhioHealth (Marion, OH)
    …implementing, communicating, managing and monitoring the needs of the physician contracting program . This role is a subject matter expert, with current knowledge of ... policies, procedures, compliance, fair market value acumen and state & federal rules and regulations. The depth of...is to: (a) lead and manage the physician contracting program by ensuring all individual physician and physician group… more
    OhioHealth (10/16/25)
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  • Reimbursement Specialist

    Fairview Health Services (Minneapolis, MN)
    …Department Interpret and demonstrate accurate application of third-party payer and government payer contracts. + Understand regulatory, HMO, PPO, Federal, State ... Perform collection tasks to obtain payments from third party payers, government , and private accounts. Negotiate payment plan arrangement with delinquent patient… more
    Fairview Health Services (11/04/25)
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  • - Specialist

    COOLSOFT (Tallahassee, FL)
    state government /public sector experience with health and human services programs preferred (such as Medicaid , MMIS, claims processing, eligibility, HHS ... analytics, SNAP, etc.). * Working knowledge of government regulations as they pertain to the advance planning document writing process. * Strong communication and… more
    COOLSOFT (12/23/25)
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  • Senior Security Professional; Executive Support

    Humana (New York, NY)
    …plans + Provide guidance and interpretation about security standards, practices, and programs to support regional and global business and security initiatives + ... Partake in continuous Executive Protection training + Maintains liaison with government , industry, and intelligence professionals + Brief Executives on geopolitical… more
    Humana (12/19/25)
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