- Molina Healthcare (Las Vegas, NV)
- …positive operational and financial outcomes. **KNOWLEDGE/SKILLS/ABILITIES** + Establishes the strategy and operational direction for provider engagement and ... years' experience in managed healthcare administration and/or Provider Services. + Provider contract network development & management experience + Project … more
- Elevance Health (Las Vegas, NV)
- …+ New Jersey, Morristown **Description** Job Description **Senior Investigator - Virginia Medicaid ** **Schedule:** 1-2 days per week in the office (Hybrid 1) ... claims. Candidate will need a strong knowledge of Virginia Medicaid . **How you will make an impact:** + Claim...and/or state. + May interface internally with Senior level management and legal department throughout investigative process. + May… more
- Elevance Health (Las Vegas, NV)
- …appropriate databases or other document management systems. + Handles Provider Contracting for Medicaid markets. **Minimum Requirements:** Requires Paralegal ... leading support staff and providing legal support services for multiple Medicaid states, enterprise-wide functions, and/or the most complex litigation through highly… more
- Elevance Health (Las Vegas, NV)
- …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
- Elevance Health (Las Vegas, NV)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- Elevance Health (Las Vegas, NV)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- Elevance Health (Las Vegas, NV)
- …distribution to providers and legal counsel. + Creates and presents settlement offers for provider issues for review and approval by management and/or legal. + ... case reviews for quality assurance, investigative sufficiency, and case data management ; and direction of day-to-day operations as assigned by management… more
- Elevance Health (Las Vegas, NV)
- …plan or a UM/benefits management firm. -Proven experience leading change management initiatives -Experience with Commercial, Medicaid , and Medicare lines of ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Elevance Health (Las Vegas, NV)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement Senior ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...perform all duties of lower-level positions as directed by management . + Participate in development and maintenance of Audit… more
- Elevance Health (Las Vegas, NV)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The Audit and Reimbursement Senior ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...all duties of lower level positions as directed by management + Participate in development and maintenance of Audit… more
- Elevance Health (Las Vegas, NV)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...perform all duties of lower-level positions as directed by management . + Participate in development and maintenance of Audit… more
- Elevance Health (Las Vegas, NV)
- …programs management with heavy emphasis in negotiation preferred. + Medicaid , Health insurance, law enforcement experience preferred. + Intermediate knowledge of ... relationship with law enforcement. + May interface internally with Senior level management and legal department throughout investigative process. + May assist in… more