- Blue KC (MO)
- …at overall data to then inform strategy around continuous improvement of healthcare delivery as well as individual decision making. + Demonstrate critical thinking ... including but not limited to Sales and Marketing, Special investigations Unit ( fraud and abuse), Legal, Product Development, Compliance and Provider Services. +… more
- UnityPoint Health (West Des Moines, IA)
- …and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in...to bill for government payers (ie, not on the Medicaid/ Medicare exclusion list.) . Document services accurately and timely… more
- Humana (Indianapolis, IN)
- …ensures adherence to policies, procedures, and regulations and to prevent and detect fraud , waste, and abuse to ensure appropriate course of action. The Quality ... the ability to travel as needed is necessary. **Preferred Qualifications** + Licensed healthcare professional in the state of Michigan: LPN, RN, LSW, LISW. +… more
- First Atlantic Health Care (Saco, ME)
- Seal Rock Healthcare , part of the Atlantic Heights Community, is a fully-licensed Medicaid/ Medicare -certified facility offering 105 beds. Our Maintenance Team at ... Cottages, 45 independent living cottages. Under the ownership of First Atlantic Healthcare , the Atlantic Heights Community follows in First Atlantic's long standing… more
- Blue KC (KS)
- …limited to Sales and Marketing, Job_Family_ID_Underwriting, PHP, Special investigations Unit ( fraud and abuse), Legal, Product Development, and Provider Services. + ... communication skills + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management… more
- CVS Health (CT)
- …improvement efforts **Preferred Qualifications** - Experience working with Medicaid and Medicare programs - Familiarity with state-specific fraud investigation ... within the Special Investigations Unit (SIU) plays a key role in supporting fraud , waste, and abuse investigations by managing and responding to Requests for… more
- Zelis (NJ)
- …negotiation with providers + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Strong understanding of ... So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more… more
- UnityPoint Health (Grimes, IA)
- …and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... We're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members. Our… more
- Zelis (FL)
- …negotiation with providers + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Understanding of ... So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more… more
- UnityPoint Health (Waterloo, IA)
- …knowledge of compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... earned us recognition as a Top 150 Places to Work in Healthcare 2022-2025 by Becker's Healthcare and among America's Best Employers By State in Iowa, Illinois… more