• Claims Research & Resolution Lead

    Humana (St. Paul, MN)
    …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 (03/22/25)
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  • Encounter Data Management Professional

    Humana (St. Paul, MN)
    …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
    Humana (03/21/25)
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  • Principal Solution Strategist - Remote

    Prime Therapeutics (St. Paul, MN)
    …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
    Prime Therapeutics (03/15/25)
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  • Account Coordinator

    CVS Health (Plymouth, MN)
    …structure the group setups within the Meritain system to align with our vendor partners (PBM's, Managed Care Entities, etc..), analytics vendors ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (03/19/25)
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