- Molina Healthcare (Sioux City, IA)
- …department inventories within the key performance requirements. * Coordinates with Customer/ Member services , Provider Services , Sales, Enrollment, UM, ... of provider disputes and appeals to ensure adherence with Medicare standards and requirements related to member ...appeals and grievance processing/resolution, including 3 years in a manager role. * Experience with Medicare Regulations,… more
- Molina Healthcare (Des Moines, IA)
- …annually or as directed by the Centers for Medicare and Medicaid Services . * Trains grievance and appeals staff, customer/ member services department, ... Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in… more
- Humana (Des Moines, IA)
- …The Manager , We are seeking a highly skilled and motivated Technology Leadership Manager to join our Service Technology team. In this role, you will play ... caring community and help us put health first** The Manager , Technology Solutions devises an effective strategy for executing...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Molina Healthcare (IA)
- …Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside ... homes, completing assessments needed for determining the types of services we need to provide. Preference will be given...and implements a case management plan, including a waiver service plan, in collaboration with the member ,… more
- Aveanna Healthcare (Cedar Rapids, IA)
- Home Health Salaried RN Assistant Clinical Manager 15K Sign On Bonus ApplyRefer a FriendBack Job Details Requisition #: 204577 Location: Cedar Rapids, IA 52401 ... On Bonus! Position Overview TheHome Health RN Assistant Clinical Manager , will evaluate nursing activities to ensure patient care,...to ensure patient care, staff relations, and efficiency of service within the team. Act as a resource and… more
- Humana (Des Moines, IA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... 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… more
- Molina Healthcare (Iowa City, IA)
- …Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not ... management software. * Targets and recruits additional providers to reduce member access grievances. * Engages targeted contracted providers in renegotiation of… more
- Access Dubuque (Dubuque, IA)
- …pm, for 80 hours per pay period. Holiday and weekend rotation. **Full-Time** The Environmental Services Lead acts as a working member of the team following the ... the philosophy, programs and initiatives of Finley Hospital and the Environmental Services Department. **Customer Service ** + Purposefully conducts all aspects… more
- Trinity Health (Des Moines, IA)
- …physician offices. Ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications and referrals. Provides excellent ... patient focused customer service and communicates effectively to service delivery...Understands the requirements of various insurance payers including capitation services and obtains insurance referrals, insurance forms, patient financial… more
- Molina Healthcare (Council Bluffs, IA)
- …face. + Experience in healthcare, home health, medical assisting, non-profits, social services , etc. Highly preferred is experience with Medicare , Medicaid, ... area/Keokuk; Iowa City are preferred locations. This position serves as a member advocate and resource connector, using knowledge of the community and resources… more
- Trinity Health (Des Moines, IA)
- …Understands the requirements of various insurance payers including capitation services and obtains insurance referrals, insurance forms, patient financial ... insurance requirements communicated by email, memorandum, educational opportunities, and in- services . Verifies patient insurance and eligibility/benefits at registration, at… more
- Molina Healthcare (Des Moines, IA)
- …the unit's daily operations to ensure prompt and appropriate outreach and coordination of services , including MTM services for Medicare and Medicaid eligible ... **Job Description** **Job Summary** Molina Pharmacy Services /Management staff work to ensure that Molina members...Technicians and other staff of a clinical pharmacy outreach service that educates patients and their health care team… more
- MPAC Healthcare (Polk City, IA)
- …with residents and their families. * Function as an active, lead member on an interdisciplinary team of physicians and nurse practitioners addressing residents' ... Responsible for all documentation requirements and keeping up-to-date on Medicare Benefit and commercial insurance plans. Key Requirements -...and therapy experience * Ability to work as a member of a team with a great attitude *… more
- MPAC Healthcare (Huxley, IA)
- …tomorrow's healthcare system. With a focus on purposeful, quality care, our comprehensive services are raising the standard in post-acute medicine. Our vision is to ... residents and their families. Our LISW's function as an active lead member on an interdisciplinary team of physicians and nurse practitioners addressing residents'… more
- Highmark Health (Des Moines, IA)
- …drug benefit strategies, drug formularies, and programs specifically for the Medicare Advantage (MA) market. The incumbent will contribute to recommendations for ... and testing processes in partnership with the pharmacy benefits manager . The successful candidate will possess excellent communication, analytical, and… more
- UnityPoint Health (Des Moines, IA)
- …. Maintain eligibility to bill for government payers (ie, not on the Medicaid/ Medicare exclusion list.) . Document services accurately and timely patient ... + Area of Interest: Behavioral Health Services + FTE/Hours per pay period: 0.4 +...treatment. In addition, this position also serves as a member of the substance abuse counselor team, provides assistance… more
- Evolent (Des Moines, IA)
- …Business Manager . + Provides medical direction to the support services review process. Responsible for the quality of utilization review determinations, ... Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),...Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Humana (Des Moines, IA)
- …including process and efficiency improvement + Conduct research on emerging products, services , protocols, and standards to improve our service offerings **Use ... and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Humana (Des Moines, IA)
- …development and modification of specifications. Develops specifications for new products/ services , applications and service offerings. Making architectural ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large.… more
- Elevance Health (Ottumwa, IA)
- …5pm CST** The **Outreach Care Specialist** is responsible for ensuring that appropriate member treatment plans are followed on less complex cases and for proactively ... members by scheduling appointments or enrolling members in programs. + Assesses member compliance with medical treatment plans via telephone or through on-site… more