- Otsuka America Pharmaceutical Inc. (Des Moines, IA)
- …for diverse stakeholders (HCPs, large healthcare organizations, payers, and specialty providers. + Experience with value-based sales models, including ... billing, coding, and reimbursement models particularly in digital health or specialty healthcare settings. + Entrepreneurial, business development mindset, with the… more
- Evolent (Des Moines, IA)
- …of our specialty programs and administrative platform. Role Overview The Associate Director role on Client Analytics will support both internal teams (EAS, ... Specialty Operations) and external partners, delivering analyses that drive...Analytics & Insights: Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover cost… more
- Travelers Insurance Company (Des Moines, IA)
- …$144,400.00 **Target Openings** 1 **What Is the Opportunity?** Bond & Specialty Insurance (BSI) provides management and professional liability, cyber, crime ... Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of claims and claim litigation to achieve superior customer service and to… more
- Molina Healthcare (Des Moines, IA)
- …applications for accuracy and completeness based on differences in provider specialty and obtains required verifications as outlined in Molina policies/procedures ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
- Humana (Des Moines, IA)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and… more
- Humana (Des Moines, IA)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... populations). + Current and ongoing Board Certification in an approved ABMS Medical Specialty + **A current and unrestricted license in KY or willing to obtain… more
- Humana (Des Moines, IA)
- …will provide sales support to the Large Group Sales Representatives in the Specialty Sales Regions. The objective will be to help execute on organizational ... team throughout the sales cycle. + Collect and organize RFP info (census, claims , RAF, etc.) and track down missing information from Broker/Client + Support sold… more
- Humana (Des Moines, IA)
- …communicates contract terms, payment structures, and reimbursement rates to our Specialty providers within the Florida region. Analyzes financial impact of contracts ... **Preferred Qualifications** + Bachelor's Degree + Experience working with medical claims + Experience with ACO/Risk Contracting + Experience with Value Based… more
- Humana (Des Moines, IA)
- …The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems of ... region of assignment + Board Certified in an approved ABMS Medical Specialty + **Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, or… more