- Public Consulting Group (Jefferson City, MO)
- …more, visit www.publicconsultinggroup.com . Summary: We are seeking a senior -level, detail-oriented and self-motivated Medicaid Waiver Evaluation Consultant ... background in data science, healthcare analytics, and a deep understanding of Medicaid waivers. **Duties and Responsibilities** + Serves as project manager and… more
- Prime Healthcare (Ontario, CA)
- …actively seeking new members to join our corporate team! Responsibilities The Senior Managed Care Biller/Collector is responsible for both billing and collections, ... in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for managed care. This includes maintaining the deficiency lists… more
- Public Consulting Group (Clint, TX)
- …federal/regional technical assistance center with deep expertise in special education, IDEA compliance , and Medicaid -financed services. They bring a strong track ... Education Improvement Services will build and sustain strategic partnerships with senior decision makers across state education agencies and will position PCG… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening ... as a key liaison, proactively addressing provider needs, ensuring regulatory compliance , and supporting operational excellence to enhance provider satisfaction and… more
- CVS Health (Chicago, IL)
- …utilization/performance, network growth, and efficiency targets. Manages and oversees compliance within our network responsibilities as provided within the state ... Medicaid contractual requirements. This position holds a variety of...others to support staff. + Process Improvement: Work with Sr . Managers and Director to develop and implement strategies… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Senior Data and Reporting Professional generates ad hoc reports and regular datasets ... and database or data warehouse queries and scripts. The Senior Data and Reporting Professional work assignments...off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer… more
- Queen's Health System (Honolulu, HI)
- …SUMMARY/RESPONSIBILITIES: * Provides work leadership and technical guidance to the Professional Billing Specialists. * Monitors work assignments to ensure accurate ... (QHS) and The Queen's Medical Center (QMC) and in compliance with federal, state, insurance carriers, health plans and...special projects as assigned. * Performs duties of a Professional Billing Specialist as needed. II. TYPICAL PHYSICAL DEMANDS:… more
- Prime Healthcare (Inglewood, CA)
- …actively seeking new members to join our corporate team! Responsibilities The Senior Medicare- Medicaid Biller/Collector is responsible for both billing and ... in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Medicare- Medicaid . This includes maintaining the… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance , Healthcare Medical Claims ... health care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare) + Medical Coding, Compliance , Payment Integrity… more
- CVS Health (Columbus, OH)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... and enhance provider networks while meeting and exceeding accessibility, compliance , quality, and financial goals and cost initiatives. Collaborates… more
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