- Molina Healthcare (Layton, UT)
- …outcomes and benefit realization + Demonstrates deep understanding of Core Operations , Claims and Enrollment processes, deliverables, vendor partners and ... responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops areas of… more
- Molina Healthcare (St. Petersburg, FL)
- …Enrollment, UM, Case Management, Claims , and other departments within Molina Medicare and Medicaid regarding A&G operations and dependencies. * Responsible ... review and/or member appeals and grievance processing/resolution, including 3 years in a manager role. * Experience with Medicare Regulations, Medicare … more
- McLaren Health Care (Flint, MI)
- We are looking for a MIG Manager Claims , to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier.... **Position Summary:** Provides overall management in providing superior claims operations for McLaren Integrated HMO Group's… more
- Good Samaritan (Kissimmee, FL)
- …Full time **Weekly Hours:** 40.00 **Department Details** **MUST HAVE 1year Medicare & Medicaid billing experience. **Job Summary** Manage the day-to-day business ... delivery, operational efficiency, the meeting of financial goals and that operations run smoothly. Supervise the implementation of policies and procedures within… more
- Elevance Health (Richmond, VA)
- …compliance with Medicare / Medicaid regulatory policies regarding FFS and zero-dollar claims . **How you will make an impact:** + Refine and build new ... coding/ claim integrity certifications strongly preferred. + Experience working with Medicare / Medicaid and associated claims return files strongly preferred.… more
- Ascendis Pharma (Princeton, NJ)
- …and develop their skills. Ascendis Pharma is looking to hire a Senior Manager , Contract Operations to join our team. Responsibilities will include implementing ... demonstrating strong leadership, project management, and communication skills. As the Senior Manager , Contracting Operations , you will be responsible for working… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply ... MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL...quality and safety standards consistent with the Centers for Medicare and Medicaid Services requirements. Assisting in the management… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER III, FACILITIES OPERATIONS AND CRAFTS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4855820) Apply MANAGER III, FACILITIES ... programs. Essential Job Functions Plans, assigns, coordinates, and manages, through subordinate Manager , Facilities Operations and Crafts staff, a variety of… more
- Hunterdon Health Care System (Flemington, NJ)
- …for supervising, planning, organizing and coordinating the daily activities of the claims processing and accounts receivables for the Acute Care billings (hospital) ... within the Revenue Cycle + Preferred: + + Bachelor's Degree in business, operations , or healthcare preferred + Minimum Years of Experience (Amount, Type and… more
- Cambridge Health Alliance (Cambridge, MA)
- …our participants. This role is responsible for overseeing Medicaid and Medicare enrollment, claims , reporting, risk adjustment, compliance, contract management, ... Lead government relations as they pertain to Health Plan Operations . * Manage all aspects of Medicare ...reporting. * Maintain secure and organized HPO data systems. ** Claims and Revenue Reporting** * Oversee Third Party Administrator… more
- Corewell Health (Grand Rapids, MI)
- Job Summary - Manager , Payment Integrity Seeking a strategic and results-driven leader to join Priority Health as a Manager , Payment Integrity. This role is ... key business functions. The ideal candidate will bring deep expertise in healthcare operations and a strong command of project management principles. You will lead… more
- Molina Healthcare (Everett, WA)
- … Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and Marketplace lines of business. This ... workflows, and escalation protocols to support efficient and compliant subrogation operations across Medicaid, Medicare , and Marketplace populations. +… more
- KONE, Inc (Moline, IL)
- **Job Title** Worker's Compensation Manager **Company Overview** Founded in 1910 _,_ KONE (https://www.kone.com/en/) is a global leader that provides elevators, ... help make people's journeys safe, convenient and reliable. Our operations in over 60 countries around the world has...move to join our team as our Worker's Compensation Manager for KONE Americas in KONE Moline, IL? +… more
- LA Care Health Plan (Los Angeles, CA)
- …etc. Collaborates with internal departments (Member Services, Provider Network Operations , Claims , Utilization Management, Pharmacy, and Quality Management) ... Manager , Customer Solution Center Appeals and Grievances Job...of care issues and work collaboratively with multiple departments ( Claims , Provider Network Operations , Utilization Management, Quality… more
- Humana (Springfield, IL)
- …help us put health first** Humana Gold Plus Integrated is seeking a Manager of Provider Engagement who leads a team of provider relations professionals responsible ... plan of Illinois through day-to-day, front-line relationship management. The Manager is responsible for facilitating a positive provider relationship management… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …as assigned by management Qualifications: + Minimum of 10 years of healthcare operations or Medicare Advantage experience; strong knowledge of Medicare ... The Provider Inquiry Manager provides leadership and oversight of claim disputes....and complex claim disputes + Identify opportunities to improve claims processing, and reduce risk and inefficiency + Analyze… more
- WesleyLife (Johnston, IA)
- …reimbursement performance and initiating new opportunities. + Lead centralized billing operations across all service lines ( Medicare A/B, Advantage, commercial, ... **Description** WesleyLife is seeking a skilled Revenue Cycle Manager to lead our centralized reimbursement and billing team. This pivotal role is responsible for… more
- BrightSpring Health Services (Louisville, KY)
- …to support the Medicare Advantage Institutional Special Needs Plan (I-SNP), the Manager will work in collaboration with all clinical and operations staff on ... Medical Services company, Population Health Management services company, and a Medicare Advantage Institutional Special Needs Plan (I-SNP).Under the direction of the… more
- Walgreens (Decatur, GA)
- …policies inclusive of participating in the billing and submission of claims to government-sponsored health care programs, including Medicare , Medicaid, ... payers, as well as the facilitating of prior authorizations on behalf of prescribers. ** Operations ** + Works with the Pharmacy Manager toward the success of the… more
- Trinity Health (Livonia, MI)
- …requirements. Comprehensive understanding of Medicare Physician Fee Schedule and Medicare Claims Processing Manual for professional services is required. ... Health Ministries to ensure consistency and integration of strategy and operations . Maintaining awareness of new industry developments and standards. Provides… more