- Syneos Health Careers (St. Louis, MO)
- Description The Field Reimbursement Manager (FRM) will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting the client's ... the products are covered under the benefit design (Commercial, Medicare Part D, Medicaid ) Support patient access to the product by providing subject matter expertise… more
- Sumitomo Pharma (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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
- Centene Corporation (Jefferson City, MO)
- …the Compliance Corrections department responsible for remediation of non- compliance issues with Medicaid , Medicare, Marketplace, and Commercial regulatory ... external corrective action plan lifecycle. Ensures data quality, interprets non- compliance trends, and develops Corrections reporting methodology in conjunction with… more
- CenterWell (Raytown, MO)
- …us put health first** **Location preference: Kansas City market/surrounding areas.** The Manager , Home Health Licensure & Regulatory Compliance leads the ... for CenterWell Home Health Licensure and Credentialing requirements. The Manager works within specific guidelines and procedures; applies advanced technical… more
- Prime Therapeutics (Jefferson City, MO)
- … 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
- Community Health Systems (Poplar Bluff, MO)
- **Job Summary** The Manager I, Clinics is responsible for overseeing the daily operations of a clinic or group of clinics, ensuring efficient delivery of patient ... coordinating healthcare services, optimizing clinic workflows, managing budgets, ensuring compliance with healthcare regulations, and providing leadership to a team… more
- CenterWell (Blue Springs, MO)
- …and third party agencies, including State Departments of Health, CMS/Medicare, Medicaid , and local governmental agencies and entities. + Conducting research of ... consumer experiences **Preferred Qualifications** + Knowledge of state regulations pertaining to compliance in the health industry + 1-2 years of healthcare / legal… more
- Gentiva (Independence, MO)
- **Overview** We're looking for a **Patient Care Manager ** to join our team.You will report directly to the Executive Director, Administrator, or Senior Patient Care ... Manager . You will be responsible for maintaining a high...and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory… more
- Datavant (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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
- Lundbeck (Lee's Summit, MO)
- …anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. **Pharmaceutical Environment/ Compliance ** ... Psychiatry Account Manager - Saint Louis West, MO Requisition ID:...on our journey of growth! As a Psychiatry Account Manager , you lead the promotion of our psychiatry portfolio,… more
- Lundbeck (Springfield, MO)
- …anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. **Pharmaceutical Environment/ Compliance ** ... Multi-Specialty Account Manager - Springfield, MO Requisition ID: 6480 Location:...the primary care and neurology settings. As an Account Manager , you lead the promotion of our psychiatry portfolio,… more
- Humana (Jefferson City, MO)
- …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
- Cardinal Health (Jefferson City, MO)
- …* 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
- CenterWell (Jefferson City, MO)
- …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 (Belton, MO)
- …Specialists (CARS), and/or CDI Liaisons with day-to-day operations + Assists Coding Manager in the review and improvement of processes and services + Ensures ... Review Tool [C-PART)) + Coordinates activities in conjunction with the Coding Manager and SSC Education staff related to the development, education, training, and… more
- Fresenius Medical Center (Cape Girardeau, MO)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... ongoing performance of other PCT's. + Collaborates with the Clinical Manager and Education Coordinator in driving organization quality standards through education… more
- Elevance Health (St. Louis, MO)
- …including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements. + Prepare settlement agreements, ... ERISA, ACA, and other federal statutes impacting health insurance preferred. + Compliance : Understanding of regulatory compliance , how to ensure adherence to… more
- Banner Health (MO)
- …initial training by both the Banner Coding Education team and your hiring manager , with continued support throughout your career here! _*This position is for ... documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code assignment. 3. Provides… more
