- Waystar (Louisville, KY)
- …hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values: ... family planning programs, including adoption assistance and fertility support + 401(K) program with company match + Pet insurance + Employee resource groups Waystar… more
- HCA Healthcare (Reston, VA)
- …purpose and integrity. We care like family! Jump-start your career as a Medicare Specialist today with Parallon. **Benefits** Parallon offers a total rewards ... (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work...vary by location._** Come join our team as a Medicare Specialist . We care for our community!… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, and timely ... reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director...issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject matter expert on… more
- CVS Health (Raleigh, NC)
- …referred to the right specialists and OSH physicians have the needed support from specialist . You'll work with senior business and engineering leaders to lead a ... delivering a new model of care for adults on Medicare . By providing comprehensive and integrated care, we improve...offer an unmatched experience for our patients. As a Senior Product Manager, you will be a key leader… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and ... to enhance provider satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account… more
- CVS Health (Madison, WI)
- …pre-certification, and predetermination of covered benefits in the commercial, Medicare , and Medicaid environment. This Wheelchair DME consultant provides subject ... and correct application of Aetna policies and practices for commercial, Medicare , and Medicaid environments. ◾Proactively use data analysis to identify opportunities… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Senior Clinical Pharmacy Specialist in the Pharmacy Services department. This is primarily a work-from-home ... expertise to develop, implement, and manage the pharmacy benefit. The Senior Clinical Pharmacist assists in managing pharmacy utilization and provides expertise… more
- University of Southern California (Alhambra, CA)
- …between the CDM residing in the billing system and CDM management tools . The Senior RI Specialist shall ensure that the Chargemaster (CDM) is consistent with ... provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date....and other third-party payers are up to date. The Senior RI Specialist delivers direction to the… more
- Molina Healthcare (Reno, NV)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member ... and/or collaboratively with other departments. **Job Duties** + Acts as a lead specialist to provide project, program , and/or initiative related direction and… more
- City and County of San Francisco (San Francisco, CA)
- …2232's may include, but are not limited to: + Disease Prevention and Control Senior Specialist /Medical Director + Provides clinical oversight of a unit or clinic ... COVID, influenza, measles, Salmonella, HIV, STIs, Tuberculosis or emerging diseases. + Senior Specialist in Forensic Pathology + Performs medicolegal autopsies… more