- Elevance Health (Norfolk, VA)
- ** Business Change Manager ** **Location:** Grand Prairie, TX; Indianapolis, IN; Mason, OH; Tampa, FL; Norfolk, VA (preferred). This role requires associates ... and adaptable workplace. Alternate locations may be considered. The ** Business Change Manager ** is responsible...and resources + Leading various projects that support the Medicare Risk & Recovery Revenue Management - Data Ops… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …TPL (Third Party Liability) claims and conditional billing + Current knowledge of Medicare Transmittal, Change Requests and the ability to understand and ... The Medicare Billing and Follow-up Representative are responsible for...with systems , payers , and processes to the manager in a timely manner . Education and Experience… more
- Prime Therapeutics (Richmond, VA)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... response strategies for regulatory changes or new laws/regulations to assist designated business area with regulatory change management efforts + Provide direct,… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- …responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. ... **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert on...in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially… more
- Humana (Richmond, VA)
- …customer, and business requirements where they can lead and manage change , remove roadblocks, and communicate clearly to multiple functional teams across digital ... and help us put health first** The Lead Product Manager conceives of, develops, delivers, and manages products for...portfolio and operations, technical, and business stakeholders. They will need to understand and work… more
- Somatus (Mclean, VA)
- …CMS guidelines. This role provides guidance and oversight to all lines of business including Commercial, Medicaid, Medicare , and Special Need Plans (SNPs). The ... and mental well-being + Community engagement opportunities + And more! The Sr. Manager , Quality, reporting to the AVP, Quality, is responsible for supporting the… more
- Humana (Richmond, VA)
- …health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs and requirements ... the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are varied and...Substance Abuse Disorder (SUD) patients. + Experience with behavioral change , health promotion, coaching and wellness. + **Must reside… more
- Kestra Medical Technologies, Inc (Roanoke, VA)
- …patients and their care teams harmoniously monitor, manage, and protect life. A Territory Manager is responsible for securing new business and managing a sales ... addition to direct sales responsibilities for a given territory, the Territory Manager provides training, on-going product service and support, and assistance in the… more
- Cardinal Health (Richmond, VA)
- …therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient support services in ... accordance with the program business rules and HIPAA regulations. This role involves care...CRM system, and this role will require resiliency to change as we will be working in a system… more
- Prime Therapeutics (Richmond, VA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Business Systems Analyst Senior - Remote **Job Description** The Business Systems ... This role leads the work direction of a team of analysts and/or business , IT, and other project stakeholders to ensure solutions are consistent with organization… more
- Elevance Health (Norfolk, VA)
- ** Business Information Consultant** **Location:** Ideal candidates will live or be willing to relocate to within 50 miles of our Pulse Point location in 5800 ... **Work Hours:** Monday to Friday, 8:00 am to 5:00 pm The ** Business Information Consultant** develops specifications and requirements for the submission of health… more
- Travelers Insurance Company (Richmond, VA)
- …Openings** 1 **What Is the Opportunity?** We are seeking a dynamic Business Systems Consultant to join our Risk Management Information Services (RMIS) Operations ... team as a Fronting Carrier Relationship Manager . You will play a crucial role in developing...file delivery, including NCCI Medical and Indemnity Data Calls, Medicare , and CA WCIRB. + Coordinate Inventory Assumption onboarding… more
- Cognizant (Richmond, VA)
- …is one of the world's leading professional services companies, transforming clients' business , operating, and technology models for the digital era. Our unique ... health plan payers, by demonstrating deep expertise in Government healthcare ( Medicare ). The Elements Product Consultant works directly with customers to understand… more
- Elevance Health (Norfolk, VA)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... + Analyzes and interprets data and makes recommendations for change based on judgment and experience. + Associates in...a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience,… more
- Evolent (Richmond, VA)
- …for improvement. Responsible for coordinating education and findings with matrixed Physician Business Manager . + Provides medical direction to the support ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Highmark Health (Richmond, VA)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... DRG/APC groups. Once identified, evaluate the cases of the change or problems and takes appropriate steps to effect...related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges… more