- Valley Behavioral Health (Salt Lake City, UT)
- …obtain certification within the first 90 days and pay will be increased Certified Case Manager range starts at $18.75 - Certified CM pay is calculated based on years ... and encourages opportunities for success. Job Summary & Deliverables The Case Manager I is a certified position that provides targeted case management and… more
- Sumitomo Pharma (Salt Lake City, UT)
- …dynamic, highly motivated, and experienced individual for the position of Sr. Manager , Medicaid Contract Administration. This position is responsible for ... managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting ...with internal departments (Internal Audit, Commercial Insights, Contracting, SOX Compliance , and Legal) to clarify policy compliance … more
- Humana (Salt Lake City, UT)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Molina Healthcare (Salt Lake City, UT)
- …for operational and strategic analysis. Maintains existing portfolio of compliance and operational reports. KNOWLEDGE/SKILLS/ABILITIES + Collaborates with customers ... and plans for closing gaps.Performs other duties as assigned by the Analytics Manager . + Completes training courses set forth by Analytics team manager .… more
- Molina Healthcare (Salt Lake City, UT)
- …integration, and a strong understanding of data governance and compliance in healthcare environments. **Knowledge/Skills/Abilities:** * Architect and implement ... Deploy, monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and … more
- Prime Therapeutics (Salt Lake City, UT)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Molina Healthcare (Salt Lake City, UT)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid , Medicare, and ... protocols to support efficient and compliant subrogation operations across Medicaid , Medicare, and Marketplace populations. + Collaborate with legal, claims,… more
- Datavant (Salt Lake City, UT)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Humana (Salt Lake City, UT)
- …a part of our caring community and help us put health first** The Manager , Technology Solutions devises an effective strategy for executing and delivering on IT ... business initiatives. The Manager , We are seeking a highly skilled and motivated...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Molina Healthcare (Salt Lake City, UT)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Negotiates agreements ... Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not… more
- Sanofi Group (Salt Lake City, UT)
- **Job Title:** Immune Hematology Manager **Location** : US Remote/Field (Located in San Francisco, CA, Salt Lake City, UT or San Jose, CA) **About the Job** The ... Immune Hematology Manager (IHM) is responsible for effectively applying promotional and...the Sanofi Team including Marketing, Managed Care, Analytics, Accounting, Compliance , Legal and other team members. + Maintain extensive… more
- Humana (Salt Lake City, UT)
- …us put health first** We're seeking a strategic, results-driven Lead Product Manager to design and deliver innovative clinical solutions that improve health outcomes ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (Salt Lake City, UT)
- …needs, support to other business units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends and provides ... + Ensures compliant with regulatory and company guidelines, including HIPAA compliance + This position primarily focuses on project/program management related to… more
- Cardinal Health (Salt Lake City, UT)
- …* Process all patient applications in accordance to set policy, procedures and PHI compliance * Speak with manufacturer field team members on case updates via phone ... benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred… more
- Molina Healthcare (Salt Lake City, UT)
- …outreach and coordination of services, including MTM services for Medicare and Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS ... to ensure prompt resolution of identified issues. * Ensures compliance with all CMS guidelines and reporting requirements for...recommended changes to drug therapy were implemented. * Assists Manager or Director in the collection and tabulation of… more
- CenterWell (Salt Lake City, UT)
- …CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and future models. Under general ... operations including program administration, contract oversight, process, performance improvement, compliance , governance, training, and more. Additionally, this role will… more
- HCA Healthcare (Salt Lake City, UT)
- …relates to I-10 training courses and materials + Work with Parallon Coding Education Manager to design education plans + Monitor QA results to assist Coding Director ... education program and provides this assessment to the Parallon Coding Education Manager + Communicate I-10 topic and/or question trends to Parallon Coding Education… more
- CenterWell (Salt Lake City, UT)
- …of outcome data, policy, procedure, and records issues. . Assure personal compliance with licensing, certification, and accrediting bodies. **Use your skills to make ... Medicine . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Excellent verbal and written communication skills . Superior… more
- Fresenius Medical Center (South Salt Lake, UT)
- …staff member present Position functions as an onsite Patient Educator and Case Manager for patients with various shifts and work hours **PURPOSE AND SCOPE:** ... a licensed nurse under organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies.… more
- Humana (Salt Lake City, UT)
- …campus and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network infrastructure environment ... for future budget forecasting and planning needs. + Communicate status updates to Manager of IT and other Senior business leaders where necessary. + Research and… more
