- AmeriHealth Caritas (Charleston, SC)
- …reimbursement set up. + Ensure that provider payment issues submitted by Provider Network Management or any other source are validated, researched and ... job is to be responsible for the maintaining current provider data and provider reimbursement set up,...healthcare claims payment configuration process/systems and its relevance/impact on network operations . + 1 to 2 years… more
- Humana (Columbia, SC)
- …Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities....closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and… more
- AmeriHealth Caritas (Charleston, SC)
- …related to healthcare claims payment configuration process/systems and its relevance/impact on network operations + Knowledge of the delivery of healthcare ... Provider billing requirements and as liaison to the Enterprise Operations Configuration Department + Participate in Provider Reimbursement medical policy… more
- CVS Health (Columbia, SC)
- …objectives. **Required Qualifications** + 10+ years of healthcare experience, preferably working with network and provider related operations and strategy. + ... it all with heart, each and every day. **Position Summary** The Lead Director, Provider Portal Strategy & Operations is responsible for the strategic leadership… more
- CVS Health (Columbia, SC)
- …day. **About the Role** We are seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across our ... Summary** Leads and ensures the delivery of high-quality internal and external Medicaid provider audit results, regulatory compliance activities, and proactive… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Network Operations Coordinator 4 maintains provider relations to support customer ... gathering of provider data needed for service operations . The Network Operations Coordinator...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment… more
- Cardinal Health (Columbia, SC)
- **_What Network and Payor Relations contributes to Cardinal Health_** Marketing is responsible for assessing customer needs, market conditions and competition to ... through developing, commercializing and monitoring the appropriate products and services. Network and Payor Relations is responsible for the development and… more
- Prime Therapeutics (Columbia, SC)
- …for a Principal Solution Strategist to help lead the Medicare and Medicaid migrations for the JUDI program.** **Job Description** The Principal Solution Strategist ... + Oversee one or more strategic initiatives in partnership with Operations and/or IT + Collaborate with all levels of cross-functional stakeholders… more
- Humana (Columbia, SC)
- …not limited to - actuarial, product strategy, product strategy advancement, and network , about the evolving footprint in accordance with Humana Dental's overall ... to participate as a QDP with respect to Exchange operations and integration for Federal and State Based health...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment… more
- Humana (Columbia, SC)
- …and help us put health first** The M&A IT integration leader will provide strategic guidance with regards to IT integration efforts to Humana's corporate development ... diligence, investment planning, integration execution, and transition to enterprise operations . The role assesses legacy environments, estimates integration impacts,… more
- Cardinal Health (Columbia, SC)
- …in Payors, PBMs, Specialty Hubs, Patient Services, Patient Assistance Programs, Medicaid , and Pharmacy Operations . . Exceptional communication, executive ... Sonexus Access and Patient Support combines best-in-class program and pharmacy operations with smart digital tools to streamline patient onboarding and increase… more
- Grant Thornton (Columbia, SC)
- …may include: + Review operational, financial, and technology processes to provide management with a comprehensive assessment of business risks, internal controls, ... the Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS). + Experience with Sarbanes-Oxley Section 404 compliance. + Proven… more