- Novo Nordisk Inc. (Minneapolis, MN)
- …Area Market Access accounts encompasses third party payers of Commercial, Medicaid and Medicare medical and prescription benefit plans. Customer channels and ... objectives for assessing customer needs. Ensure customer objectives integrate into program development (contracting, marketing programs) Create advocacy for NNI &… more
- CVS Health (Lansing, MI)
- …for State Michigan Medicaid programs for all program integrity related issues. This includes regulatory reporting , coordinating interdepartmental ... + A minimum 3 years experience in a Healthcare Program Integrity , Medicaid Special Investigation...Maryland, Nebraska, Pennsylvania + Experience with Generating / Review Medicaid State Reporting + Experience with Interpreting… more
- State of Indiana (Indianapolis, IN)
- …Medicaid departments and agency divisions to provide effective fiscal management for the Medicaid program . The Director of Medicaid Finance oversees Acute ... payment programs in support of OMPP strategic objectives including promoting Medicaid program sustainability, advancing health outcomes and improving efficiency.… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …PAHP compliance with contractual requirements to assure members receive necessary dental services; program integrity issues and accurate reporting of data to ... of Iowa, applicants should demonstrate exceptional customer service skills, integrity and a strong work ethic, along with the...Comprehend and apply state and federal code within the Medicaid program . * Understand and interpret federal… more
- CVS Health (Austin, TX)
- …or managing a production oriented team.Preferred Qualifications- Strong collaboration skills - Medicaid new state or expansion experience- Strong reporting and ... are looking for people like you who value excellence, integrity , caring and innovation. As an employee, you'll join...preferred hybrid in Texas** - Lead a team of Medicaid Provider Data Services Analyst responsible for loading and… more
- CVS Health (Hartford, CT)
- …team player to manage Risk Adjustment National Programs for the Aetna Better Health Medicaid Plans. Reporting to the Lead Director of Medicaid Risk ... activities and drive innovation while being committed to revenue integrity excellence. This position will contribute to Medicaid...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- AmeriHealth Caritas (Philadelphia, PA)
- …Responsibilities: The Director, Compliance oversees the relationship with the DHS Bureau of Program Integrity (BPI) , as it pertains to BPI initiated provider ... **Director Compliance - Medicaid Managed Care** Location: Philadelphia, PA Primary Job...Regional Compliance and establishes and maintains strong dotted line reporting to the Pennsylvania Market President(s). The Director, Compliance… more
- Genesis Healthcare (Charleston, WV)
- …make a difference.Bring your financial skills to Genesis in the role of Regional Medicaid Eligibility Manager where you will play an integral role in the achievement ... owed, to include hands on collections, center process review, auditing and reporting of results. *Collaborate with assigned nursing centers' Business Office Managers… more
- The Arc Erie County NY (Williamsville, NY)
- …and Life Plans while ensuring compliance with OPWDD and OMIG regulations. Reporting Relationship: Receives general supervision of the Program Administration ... over 65 years. The Arc Erie County is looking for a Supported Employment Program Administration QIDP! What you'll be doing: As our SEMP Program Administration… more
- CVS Health (Austin, TX)
- …the Medicaid provider management team with focus on assignment, reporting , project management, and non production activities.This role will focus on coordination ... life, every day. We are looking for people like you who value excellence, integrity , caring and innovation. As an employee, you'll join a team dedicated to improving… more
- State of Massachusetts (Boston, MA)
- …support of MassHealth members. The team is led by the Director of Program Integrity , who reports to the Deputy Medicaid Director, and consists of 10 internal ... The Deputy Program Integrity Director is a policy,...federal entities such as the Centers for Medicare and Medicaid Services, State Auditor's Office, and Office of Inspector… more
- Fairview Health Services (Minneapolis, MN)
- …all post-transplant charges for appropriate flagging as transplant related for program financial reporting . Ensures that pre-transplant/evaluation phase charges ... all data vital is present to assure accurate MCR reporting . Additionally, this position collaborates with SOT leadership in...care setting preferred. + Solid understanding of Medicare and Medicaid rules of billing related to transplant services +… more
- City of New York (New York, NY)
- …Services Program Performance Unit which serves as the primary liaison for program reporting and analysis for Client Special Services, which includes WeCARE, ... well as to Human Resources Administration's (HRA) operations and program services. OPMDA is requesting to hire one (1)...operations of Career Services contracts. - Manage the SNAP, Medicaid , and Fair Fares reporting unit, which… more
- CVS Health (Scottsdale, AZ)
- …an exciting opportunity to join our PBM Finance team as Director, Financial Performance Reporting . This is a newly created role that will lead and continue to build ... a best-in-class reporting team. CVS Health strives to continuously innovate around...of data including drug rebate, claims, financial, Medicare, Commercial, Medicaid , Exchange, and operational data. You will be responsible… more
- Trinity Health (Livonia, MI)
- …of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program , Standards of Conduct, as well as other policies ... Type:** Full time **Shift:** **Description:** **POSITION PURPOSE** Manages revenue integrity operations for the hospital(s) and/or Medical Group Provider Services… more
- Aveanna (Atlanta, GA)
- …controls within Workday processes to mitigate financial risks and uphold the integrity of financial reporting . Requirements Key Responsibilities: + SOX ... HRIS Reporting Analyst - SOX and Auditing ApplyRefer a...support of our leaders, mentors, and our tuition reimbursement program . + Celebrating Diversity:Aveanna has been recognized by Newsweek… more
- R1 RCM (Detroit, MI)
- …(RCM). + Often leading key projects to include Recovery Audit Contractors (RAC) Program , Charge Description Master (CDM), Texas Medicaid (TMHP), Transfer DRG ... As our Revenue Integrity specialist, you will be responsible for key...government audits. Every day you will provide day-to-day charge review/ reporting , denial support, appeals coordination, and reimbursement analysis. To… more
- New York State Civil Service (Albany, NY)
- …in support of audit activity.Preferred Qualifications: * Demonstrated experience working in a Medicaid program or other health insurance related program .* ... audit tools, and processes to ensure the accuracy and integrity of the privacy and security of Medicaid... data in compliance with federal, state and NY Medicaid program security requirements; * Support the… more
- Humana (Columbus, OH)
- …and data integrity as required by CMS, The Ohio Department of Medicaid , and Humana internal reporting compliance. This role will support network optimization ... data governance Ohio DSNP expansion, including developing contracting requirements, internal reporting compliance processes and supporting data integrity as… more
- Novo Nordisk (Minneapolis, MN)
- …Area Market Access accounts encompasses third party payers of Commercial, Medicaid and Medicare medical and prescription benefit plans. Customer channels and ... objectives for assessing customer needs. Ensure customer objectives integrate into program development (contracting, marketing programs) + Create advocacy for NNI &… more
