- Humana (Des Moines, IA)
- …The focus of this role is Medicare Pharmacy and Part D. The Senior Compliance Professional will analyze business requirements, provide research and ... caring community and help us put health first** The Senior Compliance Professional ensures ...Compliance or Health Plan Operations + Familiarity with Medicare pharmacy laws or regulations **Additional Information** Interview Format… more
- Humana (Des Moines, IA)
- …evaluation of variable factors. We are looking for an experienced Senior Compliance Professional specializing in Medicare Advantage to join our Field ... community and help us put health first** The IFG Senior Compliance Professional ensures ...cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare… more
- CenterWell (Des Moines, IA)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- Humana (Des Moines, IA)
- …between Humana and its trading partners, Medicare and Medicaid. The Senior Encounter Data Management Professional will work with department leadership, ... caring community and help us put health first** The Senior Encounter Data Management Professional develops business...Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools… more
- Prime Therapeutics (Des Moines, IA)
- …focus **Reporting Structure** + Reports to Sr Professional , Manager, Director or Senior Director in the Compliance department Potential pay for this position ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) -...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Des Moines, IA)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior ... Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) Certified Project Management Professional (PMP)… more
- Humana (Des Moines, IA)
- …providing frameworks to maximize available resources to achieve growth. The ** Senior Professional Business Intelligence Engineer** is an experienced individual ... a proven track record of leveraging data to meet compliance requirements and define and drive business value. The... requirements and define and drive business value. The Senior Professional will partner across various multi-disciplinary… more
- Humana (Des Moines, IA)
- …adjustment coding and documentation accuracy. The Clinical Support Team is seeking a senior professional who will be accountable for developing and maintaining ... caring community and help us put health first** The Senior Market Consultation/Partnership Professional interprets, analyzes, and...+ Help ensure accurate review of medical records for Medicare and Medicaid Risk Adjustment + Review and respond… more
- Humana (Des Moines, IA)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...Humana's long term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was… more
- Humana (Des Moines, IA)
- …of our caring community and help us put health first** The Senior Installation Administration Professional establishes and manages relationships with internal ... cards issued, claims opened for processing and certifications issued. The Senior Installation Administration Professional work assignments involve moderately… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Senior Vendor Management Professional works as liaison between vendors and organization. The ... Senior Vendor Management Professional 's work assignments involve...liaison between vendors, internal business owners, contracting, risk, and compliance teams. As part of the Humana Military Contract… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Senior Contract Management Professional evaluates, drafts, and negotiates contracts and other ... of goods and services for Humana, its subsidiaries and affiliates. The Senior Contract Management Professional work assignments involve moderately complex to… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Senior Learning Design Professional uses instructional design, cognitive psychology and adult ... knowledge or performance gap, followed by design, development, and delivery. The Senior Learning Design Professional work assignments involve moderately complex… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Senior Learning Design Professional uses instructional design, cognitive psychology and adult ... to determine the appropriate solution to a knowledge or performance gap. The Senior Learning Design Professional work assignments involve moderately complex to… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Senior Behavioral Economics Professional (SBEP) is a core member of Humana's industry-leading ... The team's work directly informs business decisions and influences broader strategies. The Senior Behavioral Economics Professional (SBEP) is a core member of… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... data requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis… more
- Humana (Des Moines, IA)
- …help us put health first** We are seeking an accomplished and experienced Senior Strategy Advancement Professional to join the Conversational Experience Platform ... business issues and opportunities, including OKR creation and evaluation. The Senior Strategy Advancement Professional will exercise considerable latitude in… more
- Trinity Health (West Des Moines, IA)
- …basics of coding diagnoses and procedures as required for insurance authorizations and Medicare compliance . Utilizes online program for Medicare ... physician offices. Ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications and referrals. Provides excellent… more
- CenterWell (Des Moines, IA)
- …put health first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist Therapeutic Subject Matter Expert monitors drug development ... factors. **Responsibilities** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist develops, maintains, and/or operationalizes strategies related… more
- CVS Health (Des Moines, IA)
- …each and every day. This is an individual contributor role The Senior Manager of Value-Based Contracting is responsible for establishing and maintaining productive ... + aligning negotiation strategies and tactics with network accessibility, quality, compliance , and financial performance goals + In charge of complete value-based… more