- Prime Therapeutics (Jefferson City, MO)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Jefferson City, MO)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- Prime Therapeutics (Jefferson City, MO)
- …make. **Job Posting Title** Claims Technical Analyst, Sr. **Job Description** The Senior Claims Technical Analyst is responsible for serving as the claims ... This role is also responsible for providing training and mentorship to Claims Technical Analysts and Associate Analysts, along with leading process improvement and… more
- HealthEdge Software Inc (Jefferson City, MO)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- CVS Health (Jefferson City, MO)
- …which contain multiple issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and ... Serves as point person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as well as other… more
- Sedgwick (Jefferson City, MO)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Senior Vice President Business Development **PRIMARY PURPOSE:** To expand and ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
- Zurich NA (Jefferson City, MO)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Jefferson City, MO)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- Prime Therapeutics (Jefferson City, MO)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- Humana (Jefferson City, MO)
- …support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated individual to influence the ... successfully position Humana to enter new markets enabling the future of the business . As a centrally positioned strategic function this team coordinates with growth… more
- Fujifilm (Jefferson City, MO)
- …please visit_ _healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** ** Senior Compliance Specialist** **Job purpose** The accomplished Senior ... Compliance Specialist will support FUJIFILM's Corporate compliance program operations to ensure high ethical standards are observed and compliance program is… more
- Cardinal Health (Jefferson City, MO)
- …colleagues as a coveted member of the Product Experience organization. As a Senior Product Experience Designer, you will define, lead, and implement the analytics ... their practices' financial performance. These products help monitor drug utilization, claims payment and denials, reimbursement trends, margins, and provide insights… more
- Cardinal Health (Jefferson City, MO)
- …of data to create innovative solutions that improve patient outcomes, streamline operations , and enhance the overall healthcare experience. We are seeking a highly ... Difference: Contribute to cutting-edge solutions that improve patient care, enhance healthcare operations , and drive positive change in the industry. + Work with a… more
- CVS Health (Jefferson City, MO)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Humana (Jefferson City, MO)
- …remote In this lead role you'll have the opportunity to analyze complex business and clinical issues leveraging healthcare and operational data to support healthcare ... collaboratively with clinicians, data scientists, actuaries, subject matter experts, and business owners across Humana to drive solutions forward. In this role… more
- Humana (Jefferson City, MO)
- …to evaluate claims data to drive deeper insights into the business and identify opportunities + Coordinate Value-Based impacts across Humana and CenterWell ... Experience in managing data to support and influence decisions on day-to-day operations , strategic planning, and specific business performance issues. + Advanced… more
- Walgreens (Jefferson City, MO)
- …customers and developing strong patient relationships. Pharmacy is the core of our business , and our pharmacy technicians enjoy all the tools and support - including ... until satisfied, etc.). + Develops strong relationships with most valuable customers. ** Operations ** + Under the supervision by the pharmacist, assist in the… more
- Cardinal Health (Jefferson City, MO)
- …and Patient Support (APS) is responsible for the tactical execution of operations of assigned program(s) for contracted client manufacturer(s). This individual will ... understanding of healthcare reimbursement (managed care and specialty pharmacy operations ). In addition to stewarding relationships with the pharmaceutical… more
- Prime Therapeutics (Jefferson City, MO)
- …(can include Government Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations , Paper Claims , Member Materials, IT, etc.) to ensure ... **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible for leading portions of departmental regulatory… more
- Centene Corporation (Jefferson City, MO)
- …that contract terms, standards and expectations are met, which includes Internal operations ( Claims , Appeals & Grievances, and Membership) + Partners with ... the quality assurance process and its integration with the business and Compliance, as well as for maintaining and...processes that will enhance overall service + Works with senior management to develop and manage strategic sourcing plans… more