- USAA (Phoenix, AZ)
- …what makes us so special! **The Opportunity** We are currently seeking a talented ** Business Process Owner I** that will support Medicare Supplement Claims for ... end-to-end claims process. This role will work with our third-party supplier and key business partners supporting our Medicare Supplement Claims. As business … more
- Evolent Health (Phoenix, AZ)
- …with Clinical Operations , Medical Leadership, IT, Provider Relations, and other business groups. **What You Will Be Doing:** + Support team responsibilities and ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...for the culture. **What You'll Be Doing:** As a Project Manager on the Medical Policy team, you will… more
- HonorHealth (Phoenix, AZ)
- …the lifecycle of the study. The position's competencies include operations , coding/billing compliance, Medicare coverage analysis/budgeting, contracting, ... finance and accounting principles. The successful Associate Clinical Trials Operations Specialist will support business activities of...a support role for pipeline, primary start up; and project modification operations within the CTO. This… more
- Humana (Phoenix, AZ)
- …to assigned business partners + Conduct periodic compliance reviews of business partner operations + Develop and monitor metrics and other oversight ... moderately complex to complex issues regarding technical approach for project components and be able to work without significant...develop and implement a plan to monitor and audit business processes related to Humana's Medicare and… more
- Humana (Phoenix, AZ)
- …products. + 5+ years of experience supporting Medicaid managed care health services operations and the Medicaid managed care business development lifecycle. + ... work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize,...and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated… more
- Public Consulting Group (Phoenix, AZ)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... . **Job-Specific Responsibilities** + Provide strong leadership on all Medicare /Medicaid cost settlement and supplemental payment projects, effectively supervising… more
- Humana (Phoenix, AZ)
- …Qualifications** + Master's Degree + Certification with Six Sigma and/or the Project Management Institute + Knowledge of Medicare Advantage **Scheduled Weekly ... Professional will work as liaison between vendors and Humana supporting internal business areas while helping ensure vendors meet contractual obligations as part of… more
- Humana (Phoenix, AZ)
- …from across the enterprise (clinical, quality, operations , analytics, and business ) and leading the end-to-end project of strategy development for ... and address business issues and opportunities related to the high-needs Medicare Advantage (MA) and Special Needs Plan (SNP) populations that benefit from payer… more
- Public Consulting Group (Phoenix, AZ)
- …+ Strategy, Architecture, Planning, and Procurement + Business Enablement + Business Solutions + Project Assurance The Medicaid marketplace is changing, and ... (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and...as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined… more
- Humana (Phoenix, AZ)
- …the customer and other key stakeholders. **Key Actions & Role Responsibilities** **_(per each project )_** + Determine the key business questions to be answered + ... will work with marketing partners and the lines of business to define a learning agenda and key strategic...alignment on research instruments including legal and compliance + Project manage the vendor through the research + Vendor… more
- Dignity Health (Phoenix, AZ)
- …assigned market(s). The position is responsible for ensuring optimal revenue operations across the market(s) of responsibility by driving revenue cycle opportunity ... identification, project management, vendor accountability, performance tracking, and partnership between...CI team, and EHR system to optimize revenue cycle operations by solving technology/build issues, interface issues, and work… more
- Humana (Phoenix, AZ)
- …years of project leadership and consulting experience. + Health Care Business Domains - Medicare , Medicaid, Group, Specialty etc. **Additional Information** ... help us put health first** Are you interested in leveraging technology and business strategy to deliver improved member experiences and health outcomes to Humana's… more
- Public Consulting Group (Phoenix, AZ)
- …federal and state law and regulation. + Reviews and is an expert in business operations for service and efficiency improvements. + Develops and executes new ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies… more
- Humana (Phoenix, AZ)
- …support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated individual to influence the ... successfully position Humana to enter new markets enabling the future of the business . As a centrally positioned strategic function this team coordinates with growth… more
- Humana (Phoenix, AZ)
- …(5) years business experience; two (2) or more years in project leadership Experience problem solving and consultation within complex environments + Facilitating ... meetings and or trainings **Preferred Qualifications:** + Master's degree in Business , Operations Management, Healthcare Administration, or related field. Eight… more
- Humana (Phoenix, AZ)
- …The individual provides data-based strategic direction to identify and address business issues and opportunities. This individual will be asked frequently to ... drawing upon their clinical knowledge and experience with clinical operations . The ideal candidate exercises independent judgment and decision...of technical experience + 2 or more years of project leadership experience + 3 or more years of… more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** CPSS Business Intelligence is a Consumer & Provider Services and Solutions team focused on data, ... reporting and data science supporting Humana's Service Operations . The team is focused on converting data to...focused on converting data to actionable insights for our business partners who can utilize to reduce administrative cost… more
- Humana (Phoenix, AZ)
- …health plan and specialty companies relative to Medicaid implementation, operations , contract compliance, and federal contract application submissions. The Lead, ... rollout is responsible for standing up provider services functions and other business functions, including people, processes, and tools, in new Medicaid markets in… more
- Humana (Phoenix, AZ)
- …Decisions are typically related to resources, approach, timeline and tactical operations for projects and initiatives involving own departmental area. Detailed role ... and consulting across teams and managing projects + Experienced with project management able to oversee and facilitate multiple projects simultaneously +… more
- Humana (Phoenix, AZ)
- …skills to create provider materials, has interpersonal skills to work across business segments, and must be highly organized. **Key Role Objectives:** + Drafting ... requirements to drive best in class provider experience. + Regular meetings with project teams to understand their provider training and education needs to ensure… more