- Vanderbilt University Medical Center (Nashville, TN)
- …Healthcare Environment, hospital, physician practice, third party payer, Medicare intermediary, health insurer, or accounting/consulting firm. (Required) 10 ... to ensure compliant and efficient clinical billing activities. Assists with both internal and external audits of data as required to identify opportunities for… more
- Highmark Health (Harrisburg, PA)
- …are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs… more
- Molina Healthcare (Columbus, OH)
- …teams. + Uses quantitative and qualitative analysis to develop and improve internal processes across the enterprise. + Recommends and facilitates process improvement ... Bachelor's degree required in a related field (Business Administration, Healthcare , Engineering, etc.) **Required Experience** 10 years of process improvement… more
- Banner Health (AR)
- …If that sounds like something you want to be a part of - apply today! Becker's Healthcare recently honored Banner as one of 150 top places to work in health care for ... 8:00 AM - 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight is in… more
- Robert Half (Boston, MA)
- JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB ... Protiviti is looking for a Risk and Compliance Senior Consultant to join our growing Healthcare team....either in professional services or industry. + Knowledge of healthcare payer regulatory requirements, including Medicare Advantage.… more
- Walgreens (Deerfield, IL)
- …$159-215-271K \#LI-TO1 **Job ID:** 1414700BR **Title:** National Director, Healthcare Consultant Relations Remote **Company Indicator:** Walgreens ... Systems, various other providers, etc), the various lines of business (Commerical, Medicare , Medicaid, etc) and the various healthcare services provided in… more
- Humana (Montgomery, AL)
- …caring community and help us put health first** The Senior Stars Improvement Consultant / Professional executes the overall Medicare Stars Improvement Program ... and management of strategies and relationships with physician groups and internal partners.. The Senior Stars Improvement Consultant / Professional… more
- Humana (Louisville, KY)
- …and help us put health first** The Long-term Growth Strategy Consultant (Distribution) provides data-based strategic direction to identify and address business ... support for the Enterprise Growth vertical. The Long-term Growth Strategy Consultant 's work involves moderately complex assignments performed with limited direction… more
- Elevance Health (Louisville, KY)
- **Medical Policy Consultant ** National Government Services is a proud member of Elevance Health Companies, Inc. family of brands. We administer government contracts ... for Medicare and partner with the Centers for ...8 am - 4:30 pm EST.** The **Medical Policy Consultant ** is responsible for researching and drafting NGS Medical… more
- WellSense (Boston, MA)
- …in provider relations or network management required + Experience in the Medicare provider healthcare insurance industry preferred **Certification or Conditions ... Sr. Provider Relations Consultant - (MA residents)-$5,000 sign on bonus WellSense Health...company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25… more
- Elevance Health (St. Louis, MO)
- **Business Information Developer Consultant - HEDIS Analytics** **Location:** This position will work a hybrid model (remote and in office one to two days per week). ... Wallingford, CT or Louisville, KY. The **Business Information Developer Consultant - HEDIS Analytics** is responsible for developing and...will be a contact for HEDIS software updates and internal team deliverables and will also manage the data… more
- Elevance Health (Manchester, NH)
- **Care Consultant Sr.** **Location** : Must reside in the state of **Maine** or **New Hampshire, and be within** 50 miles (1 hour commute) of our South Portland, ME ... working in the local office 1- 2 days per week. The **Care Consultant Sr.** for **Provider Success** is responsible for consulting with providers ( Medicare… more
- Elevance Health (Costa Mesa, CA)
- Care Consultant Sr. (California Provider Success) - JR133276 **Location** : Must reside **in the state of California** , and within 50 miles (1 hour commute) of one ... the 4 offices listed above, at least 1 day per week. The **Care Consultant Sr.** for **Provider Success** is responsible for consulting with providers (Commercial, … more
- MyFlorida (Tallahassee, FL)
- 68065014 - SYSTEMS PROGRAMMING CONSULTANT / FX TCOE TRAINING & COMMS. COORDINATOR Date: Nov 6, 2024 The State Personnel System is an E-Verify employer. For more ... Agency for Health Care Administration Working Title: 68065014 - SYSTEMS PROGRAMMING CONSULTANT / FX TCOE TRAINING & COMMS. COORDINATOR Pay Plan: Career Service… more
- Elevance Health (OH)
- **Provider Contract/Cost of Care Consultant ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The **Provider Contract/Cost of Care Consultant ** provides analytical support to the Cost of Care and/or Provider Contracting… more
- Elevance Health (St. Louis, MO)
- …employers, unions, governmental subdivisions, schools and insurance companies. We also offer Medicare plans in Illinois. The **Strategic Sales Consultant ** is ... **Strategic Sales Consultant ** **Location: St. Louis, MO, or Southern IL;...client needs related to these topics. + Coordinates with internal partners to meet and exceed client expectations, driving… more
- Highmark Health (Columbus, OH)
- …into the overall Enterprise strategy through collaboration with Senior-level internal /external stakeholders. Ensures a high degree of development, efficiency, and ... relationships within the organization, external local, regional and national healthcare industry leadership to both inform market transformation strategies as… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Behavioral Health Rates Specialist** **Job Class: Human Services Program Consultant ** **Agency: Human Services Dept** + **Job ID** : 76193 + ... and established rate-setting methodology. Manage rates analysis work and conduct internal analytical work to produce rates based on actuarially sound principles… more
- University of Washington (Seattle, WA)
- …natural beauty. **Department of Emergency Medicine has an outstanding opportunity for Research Consultant .** The University of Washington (UW) is proud to be one of ... (NIMH), National Institute on Aging (NIA), NASA, and University of Washington internal grants through the Population Health Pilot Grant, Institute of Translational… more
- US Tech Solutions (RI)
- …may be required to contact the providers of record, vendors, or internal Healthcare departments to obtain additional information. + Evaluates ... provider issues. + Independently coordinates the clinical resolution with internal /external clinician support as required. **Responsibilities:** + Reviews documentation… more