- Elevance Health (Indianapolis, IN)
- ** Process Expert II ( Medicaid Rx)** **Hybrid 1:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and ... a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The ** Process Expert II ( Medicaid Rx)** supports a single operations… more
- MyFlorida (Tallahassee, FL)
- 68900188 - OPS GOVERNMENT ANALYST II Date: Dec 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... for Health Care Administration Working Title: 68900188 - OPS GOVERNMENT ANALYST II Pay Plan: Temp Position Number: 68900188 Salary: $25.00 Hourly Posting Closing… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the BCBS Association ... Maintains accurate and up-to-date knowledge of all Government Programs regulations ( Medicaid , Medicare, Federal Employee Program, New York State Department of… more
- Stanford Health Care (Palo Alto, CA)
- …HCPCS and the American Medical Association (AMA) CPT Assistant. The SPC Coding Specialist II serves as a subject matter expert in hospital and professional ... and modifiers, group Ambulatory Payment Classifications (APCs) for billing, and process National Correct Coding Initiative (NCCI) and payer specific edits related… more
- Elevance Health (Latham, NY)
- **Behavioral Health Care Manager II - Autism** **Location:** Virtual: This role enables associate to work virtually full-time, with the exception of required ... is granted as required by law. The **Behavioral Health Care Manager II ** is responsible for performing case management telephonically and/or by home visits… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing admission requests and higher level… more
- Huron Consulting Group (Chicago, IL)
- …align resources and investments to ensure long-term sustainability. Join our team as the expert you are now and create your future. Your passion and expertise in ... of Huron's Research Office Team. As a Clinical Research Administrative Specialist II , you'll assist Huron's Research Office team in developing coverage analysis… more
- Health Care Service Corporation (Houston, TX)
- …take initiative and work independently **Preferred Job Qualifications:** + Subject Matter Expert for the Professional Provider Credentialing Process + Experience ... to support Marketing, Membership and Network Contracting across Medicare and Medicaid in Texas. Responsibilities include promoting high quality initiatives to… more
- Healthfirst (NY)
- …Financial and//or Operations QA auditors.** + **Participate as a Subject Matter Expert on various process improvement projects designed to meet departmental ... of at least two or more lines of business such as NY Medicare, Medicaid , Family Health Plus, Child Health Plus_** WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in the orientation of new staff. Level III (in addition to Level II Essential Accountabilities) + Process Management and Documentation + Identifies, recommends, ... accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National… more
- CDPHP (Latham, NY)
- …in the orientation of new staff. Level III (in addition to Level II Essential Accountabilities) + Process Management and Documentation + Identifies, recommends, ... accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is expected and required. + Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) + Offers process improvement ... lead when required Level III (in addition to Level II Accountabilities) + Displays leadership and serves as a...and desk level procedures relative to the functions + Expert and resource for escalations - Serves as subject… more
- Stanford Health Care (Palo Alto, CA)
- …a senior member of the team, this individual actively contributes to process improvement initiatives, drives innovation in financial systems, and fosters a culture ... accurate financial reporting. + Participate in the annual budget development process by providing detailed analysis and projections related to government payor… more
- State of Colorado (Denver, CO)
- …Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health ... Code & Classification Description: (New) H8G4XXRATE OR FINANCIAL ANALYST II (https://drive.google.com/file/d/0BwUD9Bt4G-21STRsY1BWTXVfdzA/view?usp=sharing&resourcekey=0-eTztQD0pz5qOj98bDXE7Ww) MINIMUM QUALIFICATIONS: Experience Only: Six (6) years… more
- Stony Brook University (East Setauket, NY)
- …Revenue Cycle experience resolving hospital Managed Care payment variances and denials. + Expert knowledge of Medicare and NY Medicaid Inpatient and Outpatient ... third party reimbursement methodology and associated healthcare claim drivers. + Expert knowledge of inpatient and outpatient billing requirements (UB-04, 837i). +… more
- Tidelands Health (Myrtle Beach, SC)
- …reduce risks to the institution. Serves as a resource and technical expert for complex coding/billing issues. Informs, educates, and coordinates with other Revenue ... Operations, and other stakeholders regarding the coding and charge capture process . Assists coding manager with coding-related projects and staff oversight. **What… more
- City of New York (New York, NY)
- …and evaluation staff members in the Epidemiology Unit. - Providing expert input on research questions, analytical guidance, research instruments, and publications; ... Surveys, Youth Risk Behavior Survey, SPARCS, Salient or other Medicaid claims databases, MEPS, BRFSS. - Ability to quickly...accommodation to participate in the job application or interview process , contact Sye-Eun Ahn, Director of the Office of… more