- Public Consulting Group (Raleigh, NC)
- …support the delivery of health-related services by helping schools access critical Medicaid reimbursement. The Consultant will take a client-centric view and ... Integrity, and other staff to execute contractual obligations. In addition, the Consultant will focus on growth and retention, ensuring that client relationships are… more
- Elevance Health (Durham, NC)
- **Behavioral Health Medical Director - Psychiatrist - North Carolina Medicaid ** **Location:** This role enables associates to work virtually full-time, with the ... Medical Director** is responsible for reviewing cases for NC Medicaid members including child and substance use disorders, and...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- COOLSOFT (Raleigh, NC)
- APD Consultant (Jobs in Raleigh, NC) Requirement id 156481 Job title Consultant Job location in Raleigh, NC Skills required Written And Verbal Communication ... Status requirement Job interview type Email Recruiter:coolsoft Job Description Consultant : Written And Verbal Communication Skills, Project Management Experience,… more
- Public Consulting Group (Raleigh, NC)
- …and the revenue generated from those identified opportunities. The Senior Consultant will manage complex projects and/or produce sophisticated deliverables; they ... and supervise staff; work independently with minimal supervision; serve as an internal consultant to other projects or product lines; play a key role in proposals… more
- CVS Health (Raleigh, NC)
- …actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job ... data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid … more
- Baylor Scott & White Health (Raleigh, NC)
- **Description - External** **JOB SUMMARY** The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
- Humana (Raleigh, NC)
- …our caring community and help us put health first** Senior Healthcare Network Consultant / Senior Network Performance Professional at Humana, you will play a pivotal ... through strategic initiatives and strong relationship-building. Senior Healthcare Network Consultant /Senior Network Performance Professional + **Provider Collaboration** :… more
- Oracle (Raleigh, NC)
- …Applies Oracle methodology, company procedures, and leading practices. As a Lead Consultant you will consult on data and modelling impacts, guiding clients through ... visualization tool like BO or Tableau + Healthcare experience with Medicaid /Medicare Claims Reporting **Expectations** + Perform other responsibilities as assigned +… more
- Vatica Health (Charlotte, NC)
- …clinically experienced and detailed-oriented nurses to join our team. As a Nurse Consultant , you will collect, review and analyze patient data to improve care ... and written + Understanding of health insurance benefit structure; especially Medicare and Medicaid + Must be technically savvy; this is critical to the role.… more
- Humana (Raleigh, NC)
- …with the organization's strategy and long-term goals. * Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that ... and consulting. + Knowledge of healthcare business domains, including Medicare, Medicaid , Group, Specialty, etc. + Development level knowledge utilizing the Power… more