- CVS Health (Hartford, CT)
- …detail-oriented Senior Manager to join our team. As the Senior Manager , Complaint & Appeals ( Medicare ) you will have a demonstrated ability to ... addressing member and provider issues promptly and efficiently. The Medicare appeals team is seeking a self-motivated...success in such an environment. In partnership with our Medicare appeals leadership team, this position will… more
- OhioHealth (Columbus, OH)
- … with updates. CGS audits and auditors Working with our legal vendor for Medicare Appeals . Working with OHA and CBSA facilities on wage index opportunities ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to ... hire a ** Medicare Appeals Clinical Leader** to lead service...recommendations and interpretations of records. + Prepare reports for senior management on appeal trends and compliance status. **Requirements:**… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Quality Control Senior Manager you want with your current employer? We have an ... Do you want to work as a Quality Control Senior Manager where your passion for creating...crucial support to the regulatory compliance team in managing appeals and improving documentation to meet regulatory standards. +… more
- Cardinal Health (Bismarck, ND)
- …can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through ... insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed. + Assist in obtaining insurance, prior authorization,… more
- CVS Health (Carson City, NV)
- …Qualifications** + Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare -Medicaid Integrated Product Experience + Experience with Part ... D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and audit management + Experience with Part C & D reporting… more
- Catholic Health (Buffalo, NY)
- …on Catholic Health (CH), reviewing opportunities and the monitoring of reimbursement. The Manager assists Senior Leadership with the review and determination of ... Overtime: Exempt: Yes Work Schedule: Days Hours: 8a-4p Summary: The Manager Government Reimbursement reports to the Director Government Reimbursement and Managed… more
- AbbVie (Detroit, MI)
- …(Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership) + Educate accounts on need-based tools to support patient ... and Buy & Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals and payor policies, and HUB services + Proven record of… more
- CenterWell (Boston, MA)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The… more