- Highmark Health (Montpelier, VT)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Centene Corporation (New York, NY)
- …5+ years of provider reimbursement and analysis experience. Experience with Medicare and Medicaid reimbursement methodology. Managed care experience and provider ... reimbursement, paid time off plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay will be adjusted based on… more
- Sanford Health (Sioux Falls, SD)
- …Hours:** 40.00 **Salary Range:** 27.50 - 38.50 **Department Details** Possibility for remote work after 6-12 months. **Job Summary** Conduct level of care medical ... with professional standards, national and local coverage determinations (NCD/LCD), centers for Medicare and Medicaid services (CMS), as well as state and federal… more
- Virtua Health (Marlton, NJ)
- …of Philadelphia for pediatrics. Location: Lippincott - 301 Lippincott Drive Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time ... core of our nursing culture. Virtua Home Care is a large, Medicare -certified home health agency that provides multidisciplinary skilled services in Burlington,… more
- Wider Circle (Southmont, NC)
- …phone or video conferencing. + A genuine interest in working with Medicare /DSNP/Medicaid populations and a commitment to building strong, supportive relationships. + ... to learn and grow in the role. + You have experience working in a remote environment and excel at working autonomously. + You have flexible availability (outside of… more
- AnMed Health (Anderson, SC)
- Remote Position Located in the heart of Anderson, South Carolina, AnMed is a dynamic, not-for-profit health system dedicated to delivering exceptional care with ... insurance payer audits. + Responsible for quarterly compliance reporting and quarterly Medicare and Medicaid credit balance reports. + Work credit balances for all… more
- Sysco (Houston, TX)
- …in Healthcare knowledge, trends, industry regulations, and reimbursement programs ( Medicare & Medicaid) required + Analytical problem-solving skills, including ... + min 50% of time is travel **Work Environment:** + Combined remote and field office setting environment AFFIRMATIVE ACTION STATEMENT: Applicants must be… more
- Molina Healthcare (GA)
- **_ Remote and must live in Georgia _** **JOB DESCRIPTION** **Job Summary** Provider Network Administration is responsible for the accurate and timely validation and ... Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST ( REMOTE ) WHO WE ARE Polaris Pharmacy Services is an ... Prior Authorization Technician - Remote Job Details Job Location Polaris Pharmacy Services...to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio… more
- Evolent (Helena, MT)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more