- 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
- Elevance Health (Durham, 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
- Public Consulting Group (Raleigh, NC)
- …providers. + Reconcile expenditures, fixed assets, and other reconciliations as needed. + Provide general ledger and reporting assistance to financial staff. + ... 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
- 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
- Humana (Raleigh, NC)
- …Senior Compliance Professional to ensure compliance as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve ... an in-depth evaluation of variable factors. The Senior Compliance Professional ( Medicaid State Reporting) will be responsible for implementing new Medicaid… 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
- Humana (Raleigh, NC)
- …consulting experience or professional experience leveraging core consulting skills to support delivering some of Medicare and Medicaid 's highest priority ... in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises the majority of… 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
- Elevance Health (Durham, NC)
- …of work completed by other associates. + Analyze and interpret data per a provider 's trial balance, financial statements, financial documents or other ... contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III**… more
- Elevance Health (Durham, NC)
- …on work completed by other associates. + Analyze and interpret data per a provider 's trial balance, financial statements, financial documents, or other ... contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs The **Audit and Reimbursement II**… more
- Cardinal Health (Raleigh, NC)
- … to discuss any missing information and/or benefit related information. + Assess patient's financial ability to afford therapy and provide hand on guidance to ... database. + Conducts outbound correspondence when necessary to help support the needs of the patient and/or program. +...missing information and/or benefit related information. + Assess patient's financial ability to afford therapy and provide … 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)
- …provides insightful and actionable metrics. + Develops and implements scalable processes that support the markets and provider engagement for the program. Engage ... health first** The Value-Based Programs Lead (Hospital Systems) supports successful value-based provider relationships with a focus on improving the provider … more
- Sedgwick (Raleigh, NC)
- …It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means ... Best-in-State Employer RN Medicare Compliance **PRIMARY PURPOSE** **:** To provide professional assessment, planning, coordination, implementation, and reporting of… 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
- Cardinal Health (Raleigh, NC)
- …direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support , and financial programs, Sonexus Health, a subsidiary of ... database + Conducts outbound correspondence when necessary to help support the needs of the patient and/or program +...to ensure the process is complete + Assess patient's financial ability to afford therapy and provide … 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
- 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
- Humana (Raleigh, NC)
- …activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. + ... inbound call center is comprised of a group of** **calls / claims / provider ** **associates researching the resolution to a pending call.** + Decisions are typically… more
- Humana (Raleigh, NC)
- …or more years of professional experience in case management, in Medicare and/or Medicaid , specifically in the delivery of care for elderly or special needs ... Management certification (CCM). + Proficiency in analyzing and interpreting financial trends. + Previous experience in utilization management, discharge planning… more