- Elevance Health (Columbia, SC)
- ** Operations Director - Medicaid ** **Location:** Columbia, South Carolina. This position will work a hybrid model (remote and office). The ideal candidate ... of our South Carolina Elevance Health PulsePoint locations. The ** Operations Director - Medicaid ** will...make an impact:** + Resolving programmatic challenges related to operations such as member issues, provider claims … more
- Serco (Washington, DC)
- …state Medicaid and CHIP fee-for-services (FFS) and managed care claims ; supporting state and national reporting; and development of corrective actions based ... of the PERM eligibility reviews, including eligibility review policies, business process; operations and contract deliverables, for estimating Medicaid and CHIP… more
- Serco (Washington, DC)
- …medical and claims reviews, including review policies, business process; operations and contract deliverables, for estimating Medicaid and CHIP eligibility ... **Position Description** Serco is seekinga motivated Assistant Program Director for Medical Claims Review to...Medicaid and CHIP fee-for-services (FFS) and managed care claims ; and supporting state and national reporting and development… more
- State of Indiana (Indianapolis, IN)
- …as stakeholder/participant technical assistance by: + Coordinating with the state Medicaid agency, stakeholders, and IDOE Legislative Affairs Director regarding ... transfers as necessary to pay participating school corporations' IndianaMAC claims and fund the state share of Medicaid...work experience in public health coverage programs policy or Medicaid program operations , or a related field.… more
- Humana (Richmond, VA)
- …diverse scope and complexity ranging from moderate to substantial. The Medicaid Lead, Technology Solutions builds strategic partnerships and manages relationships ... + **The CIO is dedicated full-time to the Virginia Medicaid product lines and must reside in the state...here on the previous bullet. + Collaborate with Market Operations /leadership in problem solving and help with workarounds as… more
- CVS Health (New York, NY)
- …and leading teams + Medicaid Network experience + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider ... Relations representatives (approximately 4) and reports to the local Lead Director . Oversees the maintenance of working relationships with the existing network… more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Claims Integrity Provider Remediation (ALD- 24 months) Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Manager, Claims Integrity Provider Remediation is responsible for development and...and external teams. Oversees team in day to day operations to include timely and accurate response on all… more
- Serco (Washington, DC)
- …state Medicaid and CHIP fee-for-services (FFS) and managed care claims ; supporting state and national reporting; and development of corrective actions based ... program management and subject matter expertise in health insurance eligibility and/or claims processing policy, particularly for the Medicaid and Children's… more
- Aveanna (Duluth, GA)
- Home Health Director of Operations ApplyRefer a FriendBack Job Details Requisition #: 195568 Location: Duluth, GA 30096 Category: Clinical Care and Support ... experience 15% Incentive Plan in addition to base salary TheExecutive Director of Operationsis directly responsible for the administrative and leadership functions… more
- Aveanna (Hibbing, MN)
- Home Health RN Executive Director of Operations ApplyRefer a FriendBack Job Details Requisition #: 195638 Location: Hibbing, MN 55746 Category: Nursing Salary: ... for the administrative and leadership functions associated with all operations of an Aveanna branch. Additionally, this individual is...if internal billing and collection efforts to generate clean claims + Perform other duties as assigned Why Join… more
- Fallon Health (Worcester, MA)
- …the Site Director . Oversees the timely and accurate processing of claims , data collection and reporting including those related to the Electronic Medical Record ... **Responsibilities** **Primary Job Responsibilities** + Provides oversight of day-to-day PACE center operations in collaboration with SE Site Director acting as… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical Director , ... Services of Lancaster General Health Physicians (LGHP) Hospitalists Program, overseeing operations and clinical quality for the consultative services and on-call… more
- Bausch Health (Bridgewater, NJ)
- …by required due dates and certification requirements. Oversight of Medicaid claims , Tricare and Coverage Gap processing operations with Third Party vendor ... validate against CMS calculated URAs in MDP prior to Operations team activating quarter within Medicaid system....within Medicaid system. Insure approval workflow of Medicaid , Tricare and Coverage Gap claims follows… more
- Humana (Richmond, VA)
- …issue resolution, and gathering of provider claims data needed for service operations . The Director , Provider Engagement is responsible for the retention of ... us put health first** Humana Healthy Horizons in Virginia is seeking a Director , Provider Engagement who will oversee the plan's strategic provider services model,… more
- HCA Healthcare (Brentwood, TN)
- …Do you want to join an organization that invests in you as a Director of Payer Engagement? At HCA Healthcare, you come first. HCA Healthcare has committed ... make a difference. We are looking for a dedicated Director of Payer Engagement like you to be a...and Qualifications** At the direction of the AVP of Operations : Collaborate with IRC, Case Management / URS, Parallon,… more
- Centene Corporation (Indianapolis, IN)
- …- Oversees staff to provide for the timely and accurate processing of Claims , Encounter forms and other information necessary for meeting Agreement requirements and ... and managing performance of staff. Managed care, insurance, Medicare or Medicaid experience preferred.Pay Range: $136,000.00 - $251,300.00 per year Centene offers… more
- Beth Israel Lahey Health (Charlestown, MA)
- …Customer Service, Cash Posting, Denial Management, and overall Revenue Cycle operations . Assist Executive Director with annual department budget preparation, ... **Work Shift:** Day (United States of America) Under oversight of the Executive Director , the Director , BILH Patient Financial Services Hospital Billing is… more
- Prime Therapeutics (Columbus, OH)
- …that are the responsibility of the Vendor. Requirements: + Extensive knowledge of Medicaid and NMAP claims processing and pharmacy benefits management. + At ... fuels our passion and drives every decision we make. **Job Posting Title** Director , Clinical Account Services - Remote Nevada **Job Description Summary** Plays a… more
- City of New York (New York, NY)
- …Responsible for ensuring the accurate and timely submissions of Homebase, Anti-Eviction and Medicaid claims . Supervise the data and correction reports within a ... SQL algorithms and EDW data, analyzing data to identify claims that can be reclaimed for higher federal and...Administrative Staff Analyst NM-I to function as a Deputy Director of Single-Issue Review, who will: Supervise three analytical… more
- Lake Erie College of Osteopathic Medicine (Defuniak Springs, FL)
- Assistant Director of Patient Care Services - School of Dental Medicine Overview Date Posted: 2/1/2024 Location: LECOM Defuniak Springs Dental Clinic Address: 101 ... Full-time Description JOB SUMMARY: We are recruiting an Assistant Director of Patient Care Services for LECOM's Dental Outreach...the clinic; + Interface with IT staff on computer operations ; + Become proficient in axiUm software and train… more