- Henry Ford Health System (Troy, MI)
- … Advantage, Medicare -Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause ... analysis when required. The Analyst will work with HAP's medical directors, nurses, pharmacists,...following established guidelines from: The Center for Medicaid and Medicare Services (CMS), MAXIMUS Federal Services, Department of Labor… more
- CVS Health (Austin, TX)
- …exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst , you will be responsible for researching, resolving, and ... members have about their coverage and benefits provided through Medicare Part D. You will have the opportunity to...construct a resolution in a timely manner. A successful Analyst is receptive to constructive feedback and flexible in… more
- The Cigna Group (Bloomfield, CT)
- **What You'll Do** The National Value-Based Partnerships Senior Analyst position is an integral member of the National Partnerships team, and will be responsible for ... best in class end-to-end administration of contract operations for Cigna Medicare 's most advanced value-based provider partnerships and health systems. Serving as… more
- The Cigna Group (Bloomfield, CT)
- …shifts with every other weekend (Tuesday ALT Day).** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C + ... Plan Medical Director. + Determine whether additional pre service, appeal or grievance reviews are required and/or whether additional appeal rights are applicable… more
- University of Washington (Seattle, WA)
- …pursuits and natural beauty. **POSITION PURPOSE** The Risk Manager's (Compliance Analyst (ES 10)) primary responsibility is to proactively manage adverse events, ... the primary intermediary with patients and their families if a formal grievance is filed. The position requires highly developed analytical skills, familiarity with… more
- Sharp HealthCare (San Diego, CA)
- …and continues implementation of EDI applications. In addition to Chargemaster Analyst , BAR and HPA/Meditech Analysts, provides management support to the PFS ... Trainer/Educator, Payment Processing staff, Shared Service Analyst , Uncompensated Care Specialist, and Hospital Auditors. The Manager is responsible for coordinating… more