- Molina Healthcare (Louisville, KY)
- …and distribute standard reports on schedule + Position reports to AVP, Payment Integrity Analytics **JOB QUALIFICATIONS** **REQUIRED EDUCATION** : + Bachelor's ... and/or Project management experience. + Managed Care experience - **_specifically within Payment Integrity , Claims Payment , Provider Relations Experience_**… more
- Molina Healthcare (Louisville, KY)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and… more
- Molina Healthcare (Louisville, KY)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Molina Healthcare (Louisville, KY)
- …workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity . + Technology Enablement: Oversee requirements, ... (Healthcare/Claims)** + Deep understanding of claims lifecycle, EDI transactions, payment integrity , provider data, appeals/grievances, and audit/compliance… more
- Lincoln Financial (Louisville, KY)
- …**The Role at a Glance** Lincoln has an opening for a **Relationship Manager ** who is passionate about helping plan sponsors and financial professionals deliver the ... best retirement plan experience possible. As a Relationship Manager , you will lead an experienced and dynamic service...+ Free financial counseling, health coaching and employee assistance program + Tuition assistance program + Work… more
- Molina Healthcare (Louisville, KY)
- …level of care, inpatient readmission, and any opportunity identified by the payment Integrity analytical team; makes decisions and recommendations pertinent to ... for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit… more
- Molina Healthcare (Louisville, KY)
- …Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical team; requires decision making pertinent to clinical ... database + Provides supporting documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by… more
- Cushman & Wakefield (Louisville, KY)
- … level initiatives including financial status, tenant improvement processing, and data integrity . * Supports process development, program improvement and quality ... building or site repairs for properties; Provide support to Operations Manager for designated projects. **Job Description** ESSENTIAL FUNCTIONS AND RESPONSIBILITIES… more
- PNC (Louisville, KY)
- …an opportunity to contribute to the company's success. As a Model Owner Manager within PNC's Technology Group, you will be based in Pittsburgh-PA, Strongsville-OH, ... aspects, model design and implementation as well as data quality and integrity . Confirms the reviews of complex reports including model documentation, model… more