- Molina Healthcare (Roswell, NM)
- …SummaryProvides subject matter expertise and leadership to healthcare services function - providing support for project/ program /process design, execution, ... into functional requirements. * Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality… more
- Molina Healthcare (Roswell, NM)
- …Summary** Provides subject matter expertise and leadership to healthcare services function - providing support for project/ program /process design, execution, ... into functional requirements. + Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality… more
- Molina Healthcare (Roswell, NM)
- **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment department to assist our diverse team of ... medical loss ratio (MLR) targets. In conjunction with the Manager of the In-Home Assessment Program , this...Programs, Market & Segment Leaders, health plan teams, member services , provider services , external vendors, actuary, and… more
- Molina Healthcare (Roswell, NM)
- **JOB DESCRIPTION** Job Summary: The AI Program Manager serves as a strategic leader driving the execution of AI initiatives to deliver meaningful business ... process improvement and organizational change management to operationalize the AI program vision. This includes end-to-end program planning (estimating,… more
- Molina Healthcare (Roswell, NM)
- …Responsible for creating, operating, and monitoring Molina Health Plan's pharmacy services programs in accordance with all federal and state laws. ... **Knowledge/Skills/Abilities** + Monitor the operational aspects of the Pharmacy Benefits Manager and other delegates to assure compliance with contractual and… more
- Genesis Healthcare (Roswell, NM)
- …**Opportunities!** **Recently Increased Wages** **Don't Forget To Ask About Our Referral Bonus Program !** At Powerback, we're on a mission to improve lives. As the ... and in school. With over 38 years of trusted service , our reach spans skilled nursing centers, assisted and...+ **Support for New Grads:** Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn… more
- Molina Healthcare (Roswell, NM)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan ... of service . **KNOWLEDGE/SKILLS/ABILITIES** + Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from… more
- Molina Healthcare (Roswell, NM)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified ... National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and… more
- Molina Healthcare (Roswell, NM)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... interpretation, and appropriate level of care for provision of member services in alignment with state, federal, accrediting, and billing/coding guidelines and… more
- Molina Healthcare (Roswell, NM)
- …oversight and expertise related to behavioral health and chemical dependency services , and assists with implementation of integrated behavioral health care programs ... management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize… more
- Molina Healthcare (Roswell, NM)
- …Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an ... Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional… more
- Molina Healthcare (Roswell, NM)
- …compliance with required reporting, and escalates identified issues to appropriate healthcare services leadership. * Maintains ongoing communication with ... functions as needed. * Educates delegates on an ongoing basis related to Molina healthcare services programs and value added benefits available in the local… more
- Molina Healthcare (Roswell, NM)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, Overpayment… more
- Walgreens (Roswell, NM)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... cash register, provides customers with courteous, fair, friendly, and efficient checkout service . + In accordance with state and federal regulations, assists the… more
- Community Health Systems (Roswell, NM)
- …review and submission of required data. + Collaborates with the Trauma Program Manager /Director, trauma medical staff, and emergency department personnel to ... trauma reporting standards. The Trauma Registrar collaborates closely with trauma program leadership, clinical teams, and regulatory bodies to support trauma … more
- Walmart (Roswell, NM)
- …** It's time to see optometry through a new lens. Walmart is revolutionizing healthcare and this your chance to be part of it. A Walmart Associate Optometrist ... is the clinical partner to the Vision Center Manager , and core to our mission of advancing eyecare affordably for everyone. About The Optometry Team We're looking… more