- Molina Healthcare (Des Moines, IA)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- Elevance Health (West Des Moines, IA)
- …Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- CenterWell (Des Moines, IA)
- …part of our caring community and help us put health first** The Manager of Pre-Bill Audit provides strategic leadership and operational oversight for the ... in unbilled rates, revenue cycle performance, and compliance. The Manager leads a team of Pre-Bill Specialists, partners with... leads a team of Pre-Bill Specialists, partners with senior leadership, and champions initiatives that enable scale and… more
- Humana (Des Moines, IA)
- …advanced agentic AI decision-making across our organization. As a Lead Technical Product Manager (PM-T), you will be responsible for shaping the vision, defining the ... and meets regulatory requirements. + Communicate complex technical concepts to senior executives in a clear, results-oriented manner. + Work with compliance… more
- CenterWell (Des Moines, IA)
- …from 7am-3:30pm EST.** + **Required to work every other holiday.** The **Care Manager , Telephonic Nurse** helps to ensure optimal continuity of care for patients ... appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a… more
- CenterWell (Des Moines, IA)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CenterWell (Des Moines, IA)
- …CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group will provide ... , a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group...the state. . Graduate of accredited MD or DO program of accredited university . Board certification or eligible… more
- CenterWell (Des Moines, IA)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel:… more
- CenterWell (Des Moines, IA)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more
- Primary Health Care (Des Moines, IA)
- …office staff for accurate registration and insurance enrollment. Collaborates with Training Manager to ensure that training program is integrated and consistent ... + Maintains knowledge of current health benefit options and practices, Medicaid, Medicare , Commercial Insurance, sliding fee discount program , and outreach along… more
- Cassia (Des Moines, IA)
- …and observations. + Develop initial and temporary care plans. + Assist Case Manager with Medicare scheduling, monthly billing, charting, and issuing notices of ... referral records, and reports. + Work in collaboration with Admissions staff, Case Manager , and Supply Coordinator. + Display a courteous attitude and respect for… more