- Public Consulting Group (Raleigh, NC)
- …support the delivery of health-related services by helping schools access critical Medicaid reimbursement. The Consultant will take a client-centric view and ... Integrity, and other staff to execute contractual obligations. In addition, the Consultant will focus on growth and retention, ensuring that client relationships are… more
- Elevance Health (Durham, NC)
- **Behavioral Health Medical Director - Psychiatrist - North Carolina Medicaid ** **Location:** This role enables associates to work virtually full-time, with the ... Medical Director** is responsible for reviewing cases for NC Medicaid members including child and substance use disorders, and...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- COOLSOFT (Raleigh, NC)
- APD Consultant (Jobs in Raleigh, NC) Requirement id 156481 Job title Consultant Job location in Raleigh, NC Skills required Written And Verbal Communication ... Status requirement Job interview type Email Recruiter:coolsoft Job Description Consultant : Written And Verbal Communication Skills, Project Management Experience,… more
- Public Consulting Group (Raleigh, NC)
- …and the revenue generated from those identified opportunities. The Senior Consultant will manage complex projects and/or produce sophisticated deliverables; they ... and supervise staff; work independently with minimal supervision; serve as an internal consultant to other projects or product lines; play a key role in proposals… more
- CVS Health (Raleigh, NC)
- …actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job ... data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid … more
- Baylor Scott & White Health (Raleigh, NC)
- **Description - External** **JOB SUMMARY** The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
- Oracle (Raleigh, NC)
- …Applies Oracle methodology, company procedures, and leading practices. As a Lead Consultant you will consult on data and modelling impacts, guiding clients through ... visualization tool like BO or Tableau + Healthcare experience with Medicaid /Medicare Claims Reporting **Expectations** + Perform other responsibilities as assigned +… more
- Humana (Raleigh, NC)
- …with the organization's strategy and long-term goals. * Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that ... and consulting. + Knowledge of healthcare business domains, including Medicare, Medicaid , Group, Specialty, etc. + Development level knowledge utilizing the Power… more
- UNC Health Care (Morrisville, NC)
- …and value-based managed care payer contracts; Medicare Advantage and Managed Medicaid managed care fee-for-service and value-based payer contracts; narrow network ... as required. The position is also a thought leader and organizational expert/ consultant in support of system growth initiatives whether clinically, operationally, or… more
- Humana (Raleigh, NC)
- …AI governance initiatives, policies, and standards. + Serve as an internal consultant and subject matter expert on Responsible AI topics such as fairness, ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more