- Highmark Health (Des Moines, IA)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Iowa Department of Administrative Services (Des Moines, IA)
- Medicaid Strategic Initiatives Manager Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4950841) Medicaid Strategic Initiatives Manager ... of nearly $7 billion. Reporting directly to the Iowa Medicaid Director, the Strategic Initiatives Manager is...of key strategic projects that support the performance and compliance of the Medicaid program. This role… more
- Humana (Des Moines, IA)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …the Medicaid program. This individual ensures effective financial management, compliance with federal and state regulations, and sustainable budgeting. The CFO ... Medicaid Finance Officer Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4949325) Medicaid...four years of full-time work as a Public Service Manager 2 or comparable management-level position. For additional information,… more
- Prime Therapeutics (Des Moines, IA)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Des Moines, IA)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Avera (Des Moines, IA)
- …Work where you matter.** **A Brief Overview** The Cost Report Reimbursement Manager will be responsible for the oversight of reimbursement associated with the ... Medicare, Medicaid , Tricare and any other governmental cost reports and...stakeholders in all Avera regions regarding reimbursement matters/issues, general compliance , and charge master compliance relative to… more
- WesleyLife (Johnston, IA)
- **Description** WesleyLife is seeking a skilled Revenue Cycle Manager to lead our centralized reimbursement and billing team. This pivotal role is responsible for ... ensuring regulatory compliance , optimizing billing and collections processes, and maximizing reimbursement...a strong focus on operational excellence, the Revenue Cycle Manager will drive performance improvements and enhance revenue cycle… more
- Pearson (Des Moines, IA)
- …path through this shifting environment to achieve continued success.** _Purpose Summary_ _The Medicaid and Vendor Implementation Manager will act as the main ... Pearson Virtual Schools' Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing… more
- Molina Healthcare (Des Moines, IA)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- Prime Therapeutics (Des Moines, IA)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Humana (Des Moines, IA)
- …our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing a comprehensive, ... holistic approach for case management throughout the continuum of care. The case manager will offer guidance. support, and coordination of the beneficiary's care as… more
- CenterWell (Des Moines, IA)
- …part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to ... and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and… more
- Humana (Des Moines, IA)
- …our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. ... The Senior Data Manager work assignments involve moderately complex to complex issues...Migration -- Planning and executing data migration projects. + Compliance -- Ensuring compliance with data protection… more
- Humana (Des Moines, IA)
- …organization and will be critical in our growth plans. The Principal Product Manager Leads all phases of the product life cycle, from inception to introduction ... Curiosity and a human-centered approach will drive the Product Manager to find relevant data and turn it into...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Des Moines, IA)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Prime Therapeutics (Des Moines, IA)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- Datavant (Des Moines, IA)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Humana (Des Moines, IA)
- …organization, and will be critical in our growth plans. The Lead Product Manager - Growth & Operations will champion the customer lifecycle, drive growth ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (Des Moines, IA)
- …needs, support to other business units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends and provides ... + Ensures compliant with regulatory and company guidelines, including HIPAA compliance + This position primarily focuses on project/program management related to… more