- Molina Healthcare (Madison, WI)
- …of knowledge although they may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, ... & Regulatory Acumen (Healthcare/ Claims )** + Deep understanding of claims lifecycle, EDI transactions, payment integrity, provider data, appeals/grievances,… more
- CVS Health (Madison, WI)
- …strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager , accounts receivable ... to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management,… more
- Zurich NA (Madison, WI)
- …**This role will be filled at either the** ** Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate level based ... + Microsoft Office experience + Knowledge of insurance regulations, markets, and products OR Senior Claims Professional: + Bachelor's Degree and 6 or more years… more
- Humana (Madison, WI)
- …The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer Business ... the Integrated Network Payment Solutions (INPS) department which falls under the Provider Process and Network Organization (PPNO). The Senior Business… more
- United Therapeutics (Madison, WI)
- …form of a public benefit corporation. Our public benefit purpose is to provide a brighter future for patients through the development of novel pharmaceutical ... audits, and driving corrective actions to completion. As a leader, you provide guidance and mentorship to your direct report, fostering precision, accountability,… more
- Fujifilm (Madison, WI)
- **Position Overview** The Regulatory Compliance Manager (Corporate) is a member of the FUJIFILM Holdings America Corporation ("HLUS") Department reporting to the ... Corporate Compliance Director. The Compliance Manager will be responsible for managing the day-to-day operations...you're shaping tomorrow's tech or redefining today's processes, we'll provide a flexible work environment and dynamic culture where… more
- Cardinal Health (Madison, WI)
- **Job Summary:** The Manager , Revenue Cycle Management, is responsible for overseeing the insurance collection follow-up team to ensure timely and accurate ... resolution of outstanding insurance claims . This role leads strategy development, performance monitoring, and process improvement initiatives to optimize cash flow,… more
- Molina Healthcare (Madison, WI)
- …Supporting the OH Plan, the candidate will act as the Ohio Operation lead on Claims and Encounters as well as the liaison to our state regulator in these areas. ... developer role but the candidate must be technically inclined and interface with IT, Claims , and Encounter Teams. Must be a self-starter willing to learn. Must be a… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …plan. This position provides guidance, coaching, and oversight to the Manager , Medical Core Content, ensuring all materials are developed with scientific ... consistency, and compliance. This position reports directly to the Senior Director, CNS Medical Communications Lead. **Job Description** **Key Responsibilities… more
- CenterWell (Madison, WI)
- …CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of ... Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex… more
- Walgreens (Madison, WI)
- …certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician. + Attends training requested by Manager and ... of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- American Family Insurance - Corporate (Madison, WI)
- …product development, marketing, and operations. You will report to Business Systems Senior Manager . Position Compensation Range: $61,000.00 - $101,000.00 Pay ... interpret enacted changes in legislation and regulation to business impact. * Provide business guidance on enacted changes in legislation and regulations to assist… more