• Medicaid Provider Hospital

    Humana (Santa Fe, NM)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (05/10/25)
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  • Provider Contracts Manager HP - Complex…

    Molina Healthcare (Roswell, NM)
    …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
    Molina Healthcare (04/30/25)
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  • Provider Contracting Executive

    Humana (Santa Fe, NM)
    …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to… more
    Humana (05/07/25)
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  • Clinical Reimbursement Coordinator, RN

    Genesis Healthcare (Albuquerque, NM)
    …long term care clinical nursing experience is required. *Experience with Medicare/ Medicaid reimbursement , MDS completion, clinical resource utilization and/or ... of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in...RN manages the overall process and tracking of all Medicare/ Medicaid case-mix documents to ensure appropriate reimbursement more
    Genesis Healthcare (05/09/25)
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  • Clinical Reimbursement Coordinator, LPN

    Genesis Healthcare (Albuquerque, NM)
    …of long-term care clinical nursing experience is required. *Experience with Medicare/ Medicaid reimbursement , MDS completion, clinical resource utilization and/or ... of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in...as required by federal and state regulations. *Manage all Medicare/ Medicaid case-mix documents at the nursing center to assure… more
    Genesis Healthcare (05/09/25)
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  • Regional Clinical Reimbursement Manager, RN

    Genesis Healthcare (Clovis, NM)
    …through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, ... in NM. Within a defined geographic area, the Clinical Reimbursement Lead models the MDS process and capability standards...support for the MDS Coordinators to meet those goals. * Provide guidance, oversight, and direction for compliance of auditing… more
    Genesis Healthcare (04/30/25)
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  • Clinical Reimbursement Coordinator, RN

    Genesis Healthcare (Clovis, NM)
    …standards of care. *Manage the overall process and tracking of all Medicare/ Medicaid case-mix documents to assure appropriate reimbursement for services provided ... through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative,… more
    Genesis Healthcare (04/17/25)
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  • Inpatient DRG Quality Auditor

    Humana (Santa Fe, NM)
    …to quality review the inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to… more
    Humana (05/10/25)
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  • Director of Nursing in Training, RN

    Genesis Healthcare (Albuquerque, NM)
    …through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, ... we serve. Responsibilities *Engage in the budgetary process, payroll analysis, reimbursement issues, and staffing ratios to become educated on the budgetary… more
    Genesis Healthcare (03/21/25)
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