- Humana (Raleigh, NC)
- …health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Organization to support the strategic direction and growth of ... more
- Humana (Raleigh, NC)
- …variable factors. **Location:** remote The Senior Project Excellence Professional for the Provider Process & Network Organization is a self-starter, team player, and ... more
- Humana (Raleigh, NC)
- …strategy to support the implementation of Humana Healthy Horizon's ( Medicaid ) virtual care provider partnerships designed to enhance member access ... more
- Humana (Raleigh, NC)
- …The Actuary - Enterprise Financial Analytics analyzes and forecasts enterprise financial , economic, and other data to provide accurate and timely information ... more
- COOLSOFT (Durham, NC)
- …data and tables in IBM Curam framework for the product delivery cases and the financial part to support all kinds of reports for case workers, DHHS controller ... more
- Prime Therapeutics (Raleigh, NC)
- …lines of business (commercial, Medicare and Medicaid ). **Responsibilities** + Build, support , and maintain financial and actuarial models + Perform and ... more
- COOLSOFT (Raleigh, NC)
- …potential service vendors. Support the development and implementation of health care provider financial supports for HIE Medicaid services and cost ... 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 ... 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 ... more
- Elevance Health (Durham, NC)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior** ... more
- CVS Health (Raleigh, NC)
- …is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by ... more
- Humana (Raleigh, NC)
- …of claims. Contributes to the investigations of fraud waste and our financial recovery. The Associate Director, Prepay Payment Integrity requires a solid ... more
- Elevance Health (Cary, NC)
- …(DME), large vendors and aggregators to ensure a home health agency can provide services to patients while maintaining financial viability; their key duties ... 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 ... 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 ... more
- AmeriHealth Caritas (Raleigh, NC)
- …are associated with the family of companies are passed onto the plans + Provide financial oversight to ensure contract compliance with suppliers; + Ensure ... more
- CenterWell (Raleigh, NC)
- …to establish risk adjustment analytics to identify coding improvement opportunities, provider coding improvement opportunities, risk score trending and tracking. + ... more
- Elevance Health (Durham, NC)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior** ... more
- Pearson (Raleigh, NC)
- …curriculum offerings. Our schools, Connections Academy and Pearson Online Academy, provide a best-in-class online learning environment for K-12 students to acquire ... more