- Immigration and Customs Enforcement (Washington, DC)
- …Patrol, Office of Field Operations, Homeland Security Investigation (HSI) and third party claims vendor ] regarding medical claims processes, trainings, and ... Claims Management Program lead for IHSC's third party claims vendor $100M+ Service Level Agreement (SLA)....to meet mission initiatives. HPMU trains field medical coordinators, managed care coordinators and referral coordinators to… more
- Humana (Washington, DC)
- …and identify opportunities to for provider education. + Ensures compliance with Oklahoma's Managed Care Contractual requirements for provider relations, such as ... first** Humana Healthy Horizons in Oklahoma is seeking a Claims Research & Resolution Lead to lead a team...+ Experience with Oklahoma Medicaid. + Thorough understanding of managed care contracts, including contract language and… more
- Humana (Washington, DC)
- …regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional ... interpretation. The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work various tasks or… more
- Prime Therapeutics (Washington, DC)
- …is client facing, and acts as a strategic liaison between the business and vendor partners to ensure the Strategic Solutions roadmap is created, managed , and ... platforms and products + Experience using queries, thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly… more