- Humana (Des Moines, IA)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Des Moines, IA)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the… more
- Avera (Des Moines, IA)
- …Report Reimbursement Manager will be responsible for the oversight of reimbursement associated with the Medicare, Medicaid , Tricare and any other ... healths, hopices, and nursing homes. Oversight includes the Medicare, Medicaid and Tricare cost reports for all entities in...clinics, nursing homes and other patient operating units. + Provide expertise, guidance, and advice to the rural network… more
- Humana (Des Moines, IA)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
- Molina Healthcare (Des Moines, IA)
- …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes * Provides data driven analytics to finance, ... performance is achieving desired results. * Keeps abreast of Medicaid and Medicare reforms and impact on the Molina...* Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment,… more
- UnityPoint Health (Des Moines, IA)
- …and across the continuum of care to develop and implement a plan to provide coordinated care to improve outcomes for our transplant patients. The financial navigator ... may be available based on the patient's individual situation. Determines Medicaid , Marketplace, other Community Resources, or UPH Financial Assistance Program as… more
- Molina Healthcare (Des Moines, IA)
- …and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and ... **JOB DUTIES** + Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to… more
- Oracle (Des Moines, IA)
- …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands on… more
- ChildServe (Johnston, IA)
- …knowledge of financial rules, regulations, and laws. + Experience with healthcare reimbursement models, including but not limited to Medicaid , Managed Care ... sustainability of the organization. In this role, you will provide strategic direction, leadership, and oversight of all financial...life. + Child Serve is a leading pediatric healthcare provider with Iowa's only children's specialty hospital ,… more
- Molina Healthcare (Des Moines, IA)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Des Moines, IA)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Des Moines, IA)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- UnityPoint Health (West Des Moines, IA)
- …to learn and level of comprehension. . Consults appropriate resources within the hospital to provide specialized education. . Demonstrates knowledge that patient ... Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance...providing appropriate teaching and making the necessary referrals to provide continuity of care. . Develops an individual plan… more
- UnityPoint Health (West Des Moines, IA)
- …to learn and level of comprehension. . Consults appropriate resources within the hospital to provide specialized education. . Demonstrates knowledge that patient ... Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance...providing appropriate teaching, and making the necessary referrals to provide continuity of care. . Assists the physician with… more
- UnityPoint Health (West Des Moines, IA)
- …four-legged family members. + Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow ... requirements within the designated time frame. + Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (eg… more
- Humana (Des Moines, IA)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more