- Highmark Health (Des Moines, IA)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Iowa Department of Administrative Services (Des Moines, IA)
- Medicaid Strategic Initiatives Manager Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4950841) Medicaid Strategic Initiatives Manager ... of nearly $7 billion. Reporting directly to the Iowa Medicaid Director, the Strategic Initiatives Manager is...of key strategic projects that support the performance and compliance of the Medicaid program. This role… more
- Humana (Des Moines, IA)
- …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
- Iowa Department of Administrative Services (Des Moines, IA)
- …the Medicaid program. This individual ensures effective financial management, compliance with federal and state regulations, and sustainable budgeting. The CFO ... Medicaid Finance Officer Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4949325) Medicaid...four years of full-time work as a Public Service Manager 2 or comparable management-level position. For additional information,… more
- Prime Therapeutics (Des Moines, IA)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Des Moines, IA)
- … 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
- Avera (Des Moines, IA)
- …Work where you matter.** **A Brief Overview** The Cost Report Reimbursement Manager will be responsible for the oversight of reimbursement associated with the ... Medicare, Medicaid , Tricare and any other governmental cost reports and...stakeholders in all Avera regions regarding reimbursement matters/issues, general compliance , and charge master compliance relative to… more
- WesleyLife (Johnston, IA)
- **Description** WesleyLife is seeking a skilled Revenue Cycle Manager to lead our centralized reimbursement and billing team. This pivotal role is responsible for ... ensuring regulatory compliance , optimizing billing and collections processes, and maximizing reimbursement...a strong focus on operational excellence, the Revenue Cycle Manager will drive performance improvements and enhance revenue cycle… more
- Humana (Des Moines, IA)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Prime Therapeutics (Des Moines, IA)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- Prime Therapeutics (Des Moines, IA)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Molina Healthcare (Des Moines, IA)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- Humana (Des Moines, IA)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Prime Therapeutics (Des Moines, IA)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- Datavant (Des Moines, IA)
- …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
- Trinity Health (Des Moines, IA)
- …make a difference and do the right thing. **Position Purpose:** The Market Manager - Provider Relations and Network Development is responsible for the strategic ... area or market of Provider Relations Managers. The Market Manager Provider Relations and Network Development will maintain a...of protocols and procedures of Centers for Medicare and Medicaid Services + Proven ability to work effectively with… more
- Molina Healthcare (Des Moines, IA)
- …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
- UnityPoint Health (West Des Moines, IA)
- …Counseling + Shift: Day Monday-Friday + Job ID: 166449 Overview Regional Manager Marketplace Exchange Days, Full-time On-site, with ability to work from Quad ... of Outreach and PFC/CAC staff to support QHP, Iowa and Illinois Medicaid year round enrollment activities. Coordinates and facilitates community outreach events and… more
- Humana (Des Moines, IA)
- …plans. Key Accountabilities We are seeking a highly skilled Lead Digital Program Manager to oversee the development and execution of a new eCommerce business. This ... independently, ensuring alignment with strategic objectives. The Lead Digital Program Manager will play a key role in establishing the structure, frameworks,… more
- Elevance Health (West Des Moines, IA)
- …by scheduling appointments or enrolling members in programs. + Assesses member compliance with medical treatment plans via telephone or through on-site visits. + ... Identifies barriers to plan compliance and coordinates resolutions. + Identifies opportunities that impact quality goals and recommends process improvements. +… more