• Senior Healthcare Program

    Staffing Solutions Organization (Albany, NY)
    …a diverse workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** ... Eligibility & Marketplace Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting Option:** This… more
    Staffing Solutions Organization (07/23/25)
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  • Sr Sourcing Specialist

    Medical Mutual of Ohio (Brooklyn, OH)
    …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides expertise to ... related field. + 5 years of experience as a Sourcing Specialist or equivalent experience. **Professional Certification(s)** + Certified Purchasing Manager… more
    Medical Mutual of Ohio (07/22/25)
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  • Sr . Specialist Application Engineer

    Waystar (Louisville, KY)
    **ABOUT THIS POSITION** While our Sr . Specialist Application Engineers are involved in multiple things throughout the Technology organization, primarily they are ... Client Success department in resolving issues relating to production processes. The Sr . Specialist Application Engineer is responsible for troubleshooting and… more
    Waystar (09/04/25)
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  • Sr . Specialist , Member & Community…

    Molina Healthcare (El Paso, TX)
    **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member ... and/or collaboratively with other departments. **Job Duties** + Acts as a lead specialist to provide project, program , and/or initiative related direction and… more
    Molina Healthcare (08/24/25)
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  • Patient Access Specialist Sr

    UCHealth (Colorado Springs, CO)
    Description Patient Access Specialist Sr , Outpatient Rehab Location: UCHealth Printers Park Med Plaza, US:CO: Springs Department: MHS Adult OP Patient Access ... physician. Verifies insurance eligibility for governmental insurance payors (ie Medicaid, Medicare , Tricare, etc.). May complete Medicare Secondary Payor… more
    UCHealth (09/13/25)
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  • Sr Specialist Site Reliability…

    Waystar (Louisville, KY)
    **ABOUT THIS POSITION** We are seeking a highly skilled and proactive Senior Specialist , Site Reliability Engineering (SRE) to help drive reliability, ... passion for automation, observability, and operational excellence. As a Senior Specialist , you'll work on complex reliability...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
    Waystar (08/28/25)
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  • Sr . Specialist Network Engineer

    Waystar (Atlanta, GA)
    …hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values: ... family planning programs, including adoption assistance and fertility support + 401(K) program with company match + Pet insurance + Employee resource groups Waystar… more
    Waystar (09/11/25)
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  • Sr . ML Specialist Application…

    Waystar (Atlanta, GA)
    …from complex PDF documents (leveraging OCR, document layout analysis, Named Entity Recognition (NER), and Relationship Extraction (RE)). + Develop rich, nested JSON ... systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out...programs, including adoption assistance and fertility support + 401(K) program with company match + Pet insurance + Employee… more
    Waystar (08/08/25)
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  • Sr . Specialist -Pharmacy Contracts…

    Sharp HealthCare (San Diego, CA)
    …**Preferred Qualifications** + 3 Years experience with managed care, PBM and/or Medicare Part D, Medicaid, Commercial Health Insurance. + Experience with Oncology ... support and performance improvement recommendations for Sharp's Patient Assistance Program .Assisting Management with supervisory responsibilities such as hiring, terminating,… more
    Sharp HealthCare (07/27/25)
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  • Sr Utiliz. Review Spclst Nurse

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating appropriate length of… more
    Houston Methodist (08/26/25)
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  • Medicare /Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, and timely ... reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director...issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject matter expert on… more
    Commonwealth Care Alliance (08/31/25)
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  • Sr Clinical Consultant - Wheelchair DME

    CVS Health (Hartford, CT)
    …pre-certification, and predetermination of covered benefits in the commercial, Medicare , and Medicaid environment. This Wheelchair DME consultant provides subject ... and correct application of Aetna policies and practices for commercial, Medicare , and Medicaid environments. ◾Proactively use data analysis to identify opportunities… more
    CVS Health (09/11/25)
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  • Senior Physician Specialist -…

    City and County of San Francisco (San Francisco, CA)
    …2232's may include, but are not limited to: + Disease Prevention and Control Senior Specialist /Medical Director + Provides clinical oversight of a unit or clinic ... COVID, influenza, measles, Salmonella, HIV, STIs, Tuberculosis or emerging diseases. + Senior Specialist in Forensic Pathology + Performs medicolegal autopsies… more
    City and County of San Francisco (08/20/25)
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  • Senior Healthcare Program

    Staffing Solutions Organization (Albany, NY)
    …a diverse workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** ... support to the other bureaus within the group, if needed. **Basic Qualifications:** + Senior Healthcare Program Specialist - Bachelor's Degree, + 8 years… more
    Staffing Solutions Organization (07/18/25)
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  • Senior Healthcare Program

    Staffing Solutions Organization (Albany, NY)
    …a diverse workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) in Albany, NY** ... will be 100% In-Office and will move to a 50% Remote Schedule.** **Duties:** The Senior Healthcare Program Specialist (level 2 or 3) will be located… more
    Staffing Solutions Organization (08/13/25)
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  • Senior Billing Specialist

    Access: Supports For Living (Middletown, NY)
    Senior Billing Specialist Location: Middletown, NY, United StatesDate Posted: Jul 31, 2025 Share: share to e-mail Apply Now Save JobSaved Description Location: ... (40hrs) Job Description: Reporting to the A/R Manager, the Senior Billing Specialist is a key position...of weekly claims processing + Analyze, billing and processing program claims for accuracy and completeness; submit claims to… more
    Access: Supports For Living (09/04/25)
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  • Senior Clinical Vendor Partnerships…

    Medical Mutual of Ohio (Brooklyn, OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Builds and sustains ... to reconcile discrepancies and identify issues, proposes solutions, and escalates issues to senior leadership as needed. . Prepares and leads weekly, monthly, and ad… more
    Medical Mutual of Ohio (07/09/25)
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  • Corporate Senior Government Reimbursement…

    Prime Healthcare (Ontario, CA)
    …preparation of various government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and ... understanding the complexity of a cost report. The Corporate Senior Government Reimbursement Specialist fully understands how one section of the report is linked… more
    Prime Healthcare (06/18/25)
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  • Senior Healthcare Program

    Staffing Solutions Organization (Albany, NY)
    …a diverse workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) in Albany, NY** ... quality assurance of the NYSOH Marketplace performance relating to program eligibility determinations, enrollment functionality and notice generation. This person… more
    Staffing Solutions Organization (09/12/25)
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  • Senior Healthcare Program

    Staffing Solutions Organization (Albany, NY)
    …a diverse workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** ... professional experience in public health insurance programs, including Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also...the federal laws relating to the F-1 STEM EAD program , SSO may be able to support a STEM… more
    Staffing Solutions Organization (07/18/25)
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