- Humana (Nashville, TN)
- …interpretation and independent determination of the appropriate courses of action. The Finance Professional 2 will support Medicaid /Duals and continue ... caring community and help us put health first** The Finance Professional 2 analyzes and forecasts financial,...membership, and premium related data to provide reports to Medicaid Finance CFOs as well as assist… more
- Humana (Nashville, TN)
- …from the data exchange between Humana and its trading partners, Medicare and Medicaid . The Senior Encounter Data Management Professional will work with ... and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of… more
- Humana (Nashville, TN)
- …community and help us put health first** The IFG Senior Compliance Professional ensures compliance with Health Plan contracts and governmental requirements. The ... Senior Compliance Professional work assignments involve moderately complex to complex issues...and reporting **Preferred Qualifications** + Bachelor's degree in Business, Finance , Law, Healthcare Administration, or a related field +… more
- Covenant Health Inc. (Knoxville, TN)
- …Forbes "Best Employer" seven times. Position Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for ... may participate in requested investigations. Maintains all organizational and professional ethical standards. Works independently under limited supervision with… more
- Prime Therapeutics (Nashville, TN)
- …flows, process change and/or project management in supporting Compliance with Medicaid requirements. + Provide direct, or indirect leadership to other compliance ... + Advise internal clients regarding compliance with State and Federal Medicaid regulatory and contractual requirements + Provides leadership to the business… more
- Elevance Health (Nashville, TN)
- …Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services ... to Medicaid plans in partnership with blue cross blue shield...minimum of 10 years of experience in healthcare operations, finance , underwriting, actuary, network development, and/or sales; or any… more
- Elevance Health (Nashville, TN)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement II** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- Humana (Nashville, TN)
- …& Clinical Innovation + Corporate Strategy & Transformation Office + Medicare & Medicaid Market Operations + Provider Relations & Network Performance + Marketing & ... Customer Engagement (including MarketPoint) + Finance , Accounting & Risk Management + Human Resources &...in a Master of Business (MBA) or other advanced professional degree (eg MPH, MD, JD, Ph.D.), with a… more
- Banner Health (TN)
- …wide array of disciplines. Whether your background is in Human Resources, Finance , Information Technology, Legal, Managed Care Programs or Public Relations, you'll ... patient care. POSITION SUMMARY This position performs full range of complex professional coding in support of specialty or multi-specialty physician practices by… more
- Banner Health (TN)
- …wide array of disciplines. Whether your background is in Human Resources, Finance , Information Technology, Legal, Managed Care Programs or Public Relations, you'll ... with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General… more
- Banner Health (TN)
- …wide array of disciplines. Whether your background is in Human Resources, Finance , Information Technology, Legal, Managed Care Programs or Public Relations, you'll ... with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General… more
- Humana (Nashville, TN)
- …couple years' experience with stakeholder management (strategy/operations at a top-tier consulting/ professional services firm) or has a successful track record at a ... banking, private equity/venture backed scaling company, corporate/business unit strategy, or finance , + Strong problem-solving skills and the ability to perform… more
- Baptist Memorial (Memphis, TN)
- …Description Minimum Required Preferred/Desired Working knowledge of current medicare, medicaid , and other regulatory IPPS/OPPS guidelines and requirements; nThrive ... Knowledge of the different types of clinical settings; Knowledge of facility and professional billing claim forms, fields, and values; Knowledge of facility and … more
- Humana (Nashville, TN)
- …directly collaborate with various business partners including initiative owners and finance stakeholders. Candidates pursuing this role should be passionate about ... of Actuaries (ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + MAAA + Strong communication skills +… more
- Humana (Nashville, TN)
- …within departments and could lead multiple managers or highly specialized professional associates. The Associate Director will own the following responsibilities: + ... to Business Administration, Information Systems, Data Science, Data Management, Finance , Economics, or related field **Additional Information** Requires some nights… more
- Baptist Memorial (Memphis, TN)
- …financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it ... relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements. Ability to recognize and communicate to clinical staff or designee when… more