- Elevance Health (Hanover, MD)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- CenterWell (Annapolis, MD)
- …+ Experience with Medicare Advantage + Experience with member level claims **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation ... many other opportunities. Application Deadline: 03-02-2025 **About us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive,… more
- Prime Therapeutics (Annapolis, MD)
- …operations systems, particularly those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, ... considering the business needs and direction. Experience serving as the senior member on business intelligence or analytics/data warehousing projects with… more
- CenterWell (Annapolis, MD)
- …for the following: clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI ... at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of...largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health… more