- Evolent (Augusta, ME)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Clinical Rules Management , Analyst ** Seeking a detail-oriented ** ... Clinical Rules Management , Analyst ** who will play a critical role in ensuring the accuracy and integrity of our clinical rule engine, impacting our … more
- Highmark Health (Augusta, ME)
- …job works collaboratively riskacross Highmark Health clinical areas to support clinical quality auditing, The Senior Risk Compliance Analyst is responsible ... subject matter expert, providing insights and guidance to internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and… more
- Intermountain Health (Augusta, ME)
- **Job Description:** The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns ... codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical… more
- Intermountain Health (Augusta, ME)
- …the patient's account within Intermountain's policies and procedures. **Revenue Integrity Analyst II** 1.Analyze data, develop reports, review trends, and recommend ... site teams, external business partners/vendors, compliance, legal counsel, health information management , and designated areas in the response process. 5. Assists… more
- Cardinal Health (Augusta, ME)
- … team to onboard new practices including Assessment Call and giving direction to Clinical Analyst owning account * Once the Rheum team grows, manage the ... training and oversite of all new Clinical Analyst Team members (working with HR,...Specialty Network requirements of the Provider Solutions, Customer Success, management , and HR Handbook rules * Assist… more
- CenterWell (Augusta, ME)
- …Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. This individual will ... Medicare, population health, Accountable Care Organizations (ACOs), medical group management / practice management , health plans /...necessary / required actions initiated by CMS * Oversee rules and regulations of ACO programs as outlined in… more