- Humana (Washington, DC)
- …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
- HealthEdge Software Inc (Washington, DC)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
- Takeda Pharmaceuticals (Washington, DC)
- … Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Humana (Washington, DC)
- …experience with mid-size projects. + 2+ years of experience working with managed healthcare contracts, including an understanding of provider contract language. + ... and/or Medicaid health plan operations, such as provider relations, claims submission and payment, utilization management processes, behavioral health processes,… more
- Microsoft Corporation (Sterling, VA)
- …and outbound deliveries as instructed by management. You will initiate warranty claims and process returns on failed equipment. This opportunity will allow you ... Centers in 32 countries and millions of servers. Our foundation is built upon and managed by a team of subject matter experts working to support services for more… more