- General Dynamics Information Technology (Raleigh, NC)
- …2 + years of related experience **Job Description:** Accounting Assistant I The ** Medicaid Provider Financial Support Specialist** serves as ... or more functional areas of Accounting or Financial Services. Provider in-depth understanding of Medicaid reimbursement policies, claim processing, billing… more
- HCA Healthcare (Sanford, NC)
- …environment where diversity and inclusion thrive? Submit your application for our Medicaid Eligibility Advocate opening with Central Carolina Hospital today and find ... Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a 100% match...Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more
- Elevance Health (Raleigh, NC)
- …and provider needs; identifies needs for community and other support programs, resources and linkages. + Identifies and develops opportunities for innovation ... Care Management to lead the care management team in Medicaid Regions 4 and 6 in the state of...social determinates of health (SDOH), and other strategies that support comprehensive, integrated care planning. + Supervise and … more
- CVS Health (Raleigh, NC)
- … experience. **Required Qualifications** -5 or more years of relevant financial experience -Medicare and/or Medicaid experience **Preferred Qualifications** - ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...adjustments, determinations, program changes, and will report on the financial impact as well as determine rate adequacy for… more
- Humana (Raleigh, NC)
- … provider facing educational materials, managing non-standard language and financial terms processes, and supporting contractors through VBP amendment negotiation ... in-depth understanding of VBP and the contracting process to support value based programs, effective communication, and ability to...that contractors can use + Coordinates review of non-standard financial terms with Medicaid VBP leadership and… more
- Humana (Raleigh, NC)
- …The Actuary - Enterprise Financial Analytics analyzes and forecasts enterprise financial , economic, and other data to provide accurate and timely information ... decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial , and market… more
- UNC Health Care (Morrisville, NC)
- …review, and internal consulting in preparation for filing the annual Medicare, Medicaid , and Champus/Tricare cost reports for UNC Health Care System. Prepares cost ... and related supporting reserve worksheets for the CFO's to use in financial statement preparation. Collaborates with Management in the reimbursement regulations and… more
- Humana (Raleigh, NC)
- …Pharmacy Claims Professional will play a pivotal role in Pharmacy Financial Recovery initiatives. Additionally, they will analyze and address inquiries regarding ... authorized to work in the US without Humana sponsorship as Humana does not provide work visa sponsorship for this role.** **_Work at Home Guidance_** **_To ensure… more
- Public Consulting Group (Raleigh, NC)
- …of financial , residential, and asset verification. + Financial software to support the reporting of public provider costs to determine Medicaid ... PCG Health team helps our clients meet the complex financial , regulatory, and operational challenges of today's changing health...of today's changing health care landscape, so they can provide the best care, most effectively, to those they… more
- Public Consulting Group (Raleigh, NC)
- …as needed. + Prepare Medicaid cost reports for ambulance providers. + Provide general ledger and reporting assistance to financial staff. + Ensure compliance ... and recommend accounting process improvements. + Assist with the Medicaid cost report audit support and documentation....Assist with the Medicaid cost report audit support and documentation. + Responsibilities may change as the… more
- Highmark Health (Raleigh, NC)
- …to implementation) of VBR programs for key strategic accounts and/or initiatives. Support strategic provider relationships to understand the current health ... internal areas of the enterprise such as the strategic, financial , and clinical leadership of the enterprise, in addition...consultants to explain new programs and results to key provider partners. + Collaborate with and support … more
- Humana (Raleigh, NC)
- …+ Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena **Preferred Qualifications** + ... caring community and help us put health first** The Director, BH Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other … more
- Humana (Raleigh, NC)
- …primary role is to develop organized analytics, reports and data management to support the market's Quality team within the Medicaid product line. Integrates ... Makes decisions on moderately complex to complex opportunities which may support Member Engagement, Clinical Performance, Provider Engagement, Behavioral Health… more
- Mathematica (Raleigh, NC)
- …policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. Mathematica offers ... owned. As an employee stock owner, you will experience financial benefits of ESOP holdings that have increased in...analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data… more
- Humana (Raleigh, NC)
- …an experienced team member with meaningful management consulting experience to support delivering high priority projects and initiatives across our insurance ... products (including Medicare, Medicaid , Med Supp, PDP, and others), with an emphasis...across the company + Conducting industry, market, competitor, and financial analysis + Working collaboratively with fellow team members… more
- Evolent (Raleigh, NC)
- …plan-agnostic company, we currently partner with more than 70 plans and risk-bearing provider groups to better manage both the quality and cost of care. Through ... comprehensive suite of resources-such as high-value clinical pathways, electronic decision support and value-based payment models-we create an ecosystem that helps… more
- Humana (Raleigh, NC)
- …coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more
- Humana (Raleigh, NC)
- …help us put health first** The Primary Care Organization Finance team helps support the Conviva and CenterWell clinic operations, which have more than 200 centers ... country and jointly serves as the nation's preeminent patient-centric primary care provider for seniors. The Senior Finance Professional will complete financial … more
- Humana (Raleigh, NC)
- …Strategy team. The Primary Care Organization is Humana's senior-focused healthcare provider . Our national primary care centers provide value-based care ... includes analyzing market trends, consumer behaviors, and competitive dynamics to support marketing strategies that enhance brand positioning and increase market… more
- Prime Therapeutics (Raleigh, NC)
- …lines of business (commercial, Medicare and Medicaid ). This role will also provide actuarial support in complex projects that are highly visible to senior ... leadership and across the organization. **Responsibilities** + Own, build, support , and maintain financial and complex actuarial models + Lead, perform, and… more