- Prime Therapeutics (Annapolis, MD)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Annapolis, MD)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- HealthEdge Software Inc (Annapolis, MD)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- UIC Government Services and the Bowhead Family of Companies (Aberdeen, MD)
- **Overview** NETWORK SPECIALIST - SENIOR (HITS-R): Bowhead seeks a Network Specialist, Senior to support the High Performance Computing Modernization Program ... - Provides technical guidance for directing and monitoring information systems operations . - Designs, builds, and implements network systems. - Directs compilation… more
- Elevance Health (Hanover, MD)
- **Clinical Provider Auditor Senior - Maryland Behavioral Health** **Supports Payment Integrity & Behavioral Health** _Location: This position will work a hybrid ... analytics to improve the delivery of care. The **Clinical Provider Auditor Senior ** is responsible for identifying issues and/or entities that may pose potential… more
- Zurich NA (Annapolis, MD)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Annapolis, MD)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- Prime Therapeutics (Annapolis, MD)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- CareFirst (Columbia, MD)
- …relate to risk mitigation and effective external/internal controls for CareFirst Business Operations . + Initiates claim adjustments, court ordered restitution, ... execute investigative plans that may include performance of audits of financial business records, provider and subscriber medical data, claims , systems? reports,… more
- Stantec (Baltimore, MD)
- Senior Document Controls Manager - ( 240003NP ) **Description** We are strategizing, planning, and implementing projects that help clients achieve their ... as if they were our own, our project management business , and technical experts work with clients to strategize,...to wind farms. **Your Opportunity** Stantec is seeking a Senior Document Controls Manager to join our growing team!… more
- Fujifilm (Annapolis, MD)
- …please visit_ _healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** ** Senior Compliance Specialist** **Job purpose** The accomplished Senior ... Compliance Specialist will support FUJIFILM's Corporate compliance program operations to ensure high ethical standards are observed and compliance program is… more
- Prime Therapeutics (Annapolis, MD)
- …file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations . **Job Description** + Effectively ... and drives every decision we make. **Job Posting Title** Senior Enrollment Specialist **Job Description Summary** This position is...supports Magellan's SBU program operations ensuring that data is entered accurately and timely… more
- Cardinal Health (Annapolis, MD)
- …colleagues as a coveted member of the Product Experience organization. As a Senior Product Experience Designer, you will define, lead, and implement the analytics ... their practices' financial performance. These products help monitor drug utilization, claims payment and denials, reimbursement trends, margins, and provide insights… more
- Cardinal Health (Annapolis, MD)
- …of data to create innovative solutions that improve patient outcomes, streamline operations , and enhance the overall healthcare experience. We are seeking a highly ... Difference: Contribute to cutting-edge solutions that improve patient care, enhance healthcare operations , and drive positive change in the industry. + Work with a… more
- CVS Health (Annapolis, MD)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Trinity Health (Silver Spring, MD)
- …Position is based on East Coast **POSITION PURPOSE** Functions as the Operations Manager responsible for the direct supervision of supervisors and/or staff and ... coordination of the day-to-day operations in assigned area of the Regional Health Ministry's...department. Assigned area(s) may include Retail Services, Production and/or Business Manager. Assists in development and management of preliminary… more
- Conviva (Annapolis, MD)
- …and help us put health first** The Revenue Cycle Manager (Onshore Operations ) oversees the onshore team responsible for the comprehensive management of revenue ... Professional and Payment Posting Auditors who work to ensure accurate financial operations and proper payment posting. The manager is also responsible for process… more
- Army National Guard Units (Baltimore, MD)
- …and application of statutes, rules, and regulations as they pertain to contracts, claims , or other legal instruments involving private business , state, local, ... a member of the management negotiating team. Serves as claims officer for the State. Prepares claims ...in providing legal interpretation and guidance to managers and senior leaders on United States Code Title 32 |… more
- UIC Government Services and the Bowhead Family of Companies (Aberdeen, MD)
- …a team. + Five (5) years combined experience in System Engineering, Business Management, Operations Strategy, process improvement, schedule management, or ... classified and unclassified formal meetings and reviews, including coordination with senior executive and flag officer staff within research, acquisition, and… more
- Humana (Annapolis, MD)
- …remote In this lead role you'll have the opportunity to analyze complex business and clinical issues leveraging healthcare and operational data to support healthcare ... collaboratively with clinicians, data scientists, actuaries, subject matter experts, and business owners across Humana to drive solutions forward. In this role… more