- CVS Health (Scottsdale, AZ)
- … managed care organization. In partnership with and under the direction of the Chief Medicaid Compliance Officer and Medicaid Compliance leadership team, ... other key department projects and initiatives to improve and enhance Aetna's Medicaid Compliance program, and serve as the compliance representative on… more
- Sumitomo Pharma (Phoenix, AZ)
- …currently seeking a dynamic, highly motivated, and experienced individual for the position of ** Sr . Manager , Medicaid Contract Administration.** The Sr . ... , Medicaid Contract Administration is responsible for managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid … more
- Molina Healthcare (Phoenix, AZ)
- …and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality ... more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-, program-, and… more
- HealthEdge Software Inc (Phoenix, AZ)
- **Overview** **Position** **Overview:** As a Senior Product Manager , within theclaimsvalue stream forHealthRulesPayor, you will have ownership of system ... **What** **You Bring** **: ** + 5+ years' experience as a product manager in a **SaaS-based, Agile** /Scrum technology company including all related processes (eg… more
- HealthEdge Software Inc (Phoenix, AZ)
- **Overview** **Position Overview** **:** As aSenior Manager ,Product ManagementforHealthEdgeSource, you willbededicatedto developing innovative solutions for the ... and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for… more
- CVS Health (Scottsdale, AZ)
- …is responsible for leading the delivery of Aetna quality and compliance efforts, cross-functional reporting, and cultural transformation. This position will be ... Qualifications** - Registered Nurse - 2 years experience working with Medicaid or Exchange Contract Requirements **Education** Bachelor's Degree or equivalent… more
- Banner Health (AZ)
- …with regard to interpretation of coding guidelines prior to referral to senior manager , educator or Coding Quality Analyst. MINIMUM QUALIFICATIONS High ... for growth in this exceptional team environment. Looking for a motivated, experienced ** Senior Complex Inpatient Facility | Acute Care | HIMS Coder -Remote | Medical… more
- Banner Health (Phoenix, AZ)
- …assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state ... Medicaid plans, Center for Medicare Services (CMS), Office of...make needed corrections and ensure accurate coding, reimbursement, and compliance . 7. Provides mentoring for less experienced staff members… more
- CenterWell (Sun City, AZ)
- …Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 290 centers across ... care team supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care, we want to help those in the communities we… more
- Banner Health (Tucson, AZ)
- …claims. 3. Refers fee schedule, vendor contract, plan problems or concerns to manager or senior level processors for intervention. Enters Siebel requests for ... queues and lists, logging and processing claims efficiently. Prior experience with Medicaid claims processing is highly desirable for this position. The position is… more
- CenterWell (Mesa, AZ)
- …primary care 'on-call' program of CenterWell as needed. * Assures personal compliance with licensing, certification, and accrediting bodies. * Spend 100% of your ... and unrestricted DEA license * Medicare Provider Number * Medicaid Provider Number * Minimum of two to five...insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care… more
- Mathematica (Phoenix, AZ)
- …opportunities in Commercial HCLS, including serving on proposal teams as a proposal manager . You will also work closely with Mathematica's corporate legal team as ... and opportunities in HCLS, including serving on proposal teams as proposal manager . * Develop budget specifications and review budget materials for proposals and… more
- Banner Health (AZ)
- …with regard to interpretation of coding guidelines prior to referral to senior manager , educator or Coding Quality Analyst. MINIMUM QUALIFICATIONS High ... documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code assignment. 3. Provides… more