3mo
Save
Mark Applied
Hide
Market Physician Executive (MPE) - Float
Nashville or Memphis or Georgia or Virginia
RemoteFull Time
MD/DO with state licenses, board certification in nephrology/internal medicine or related specialty, eligible for hospital privileges, experience with Medicare/Medicaid, NCQA/HEDIS knowledge.
Salesforce, Athena Health
5d
Save
Mark Applied
Hide
Appeals & Grievances Quality Auditor
Arkansas or Arizona or Florida or Georgia or Iowa or Illinois or Kansas or Kentucky or Michigan or Minnesota or Missouri or North Dakota or Nebraska or Oklahoma or South Dakota or Tennessee or Texas or Virginia or Wisconsin
$57k-$85k/yr RemoteFull Time
5+ YOEBachelor's degree or equivalent experience and 5 years directly in health plan appeals & grievances; strong audit, analytical, regulatory (CMS/NCQA) and quality improvement skills.
1w
Save
Mark Applied
Hide
Senior Regulatory Implementation and Assurance Analyst
Pennsylvania or Maryland or Washington or North Carolina or Louisiana or Kentucky or Kansas or Indiana or Illinois or Georgia or Iowa or Florida or Colorado or California or Delaware or Connecticut or Arkansas or Arizona or Alabama or Alaska or Nevada or Vermont or Tennessee or Idaho or Oklahoma or Hawaii or Mississippi or Utah or New Hampshire or New Mexico or Wyoming or North Dakota or South Dakota or Rhode Island or West Virginia or Missouri or Texas or District of Columbia or Ohio or New Jersey or Oregon or South Carolina or Virginia or Massachusetts or Nebraska or Minnesota or Michigan or Wisconsin or New York or Maine
$79k-$127k/yr HybridFull Time
5+ YOE5+ years interacting with regulators/auditors, bachelor’s degree or equivalent experience, knowledge of regulatory frameworks (HIPAA, NIST, PCI, CMS, NCQA), strong communication, analytics, and project leadership skills.
3w
Save
Mark Applied
Hide
Provider Performance Specialist-Senior
Alabama or Alaska or Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Maryland or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Rhode Island or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
4+ YOEBachelor\u0002s or equivalent, 4 years payer/ACO/value-based care experience, advanced Excel and Power BI/Tableau, knowledge of Medicare Advantage/Medicaid/NCQA, strong analytical and communication skills.
Microsoft Excel, Power BI, Tableau
2w
Save
Mark Applied
Hide
Provider Credentialing Rep
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$44k-$52k/yr RemoteFull Time
2+ YOEHigh school diploma/GED, 2+ years provider credentialing and provider data system experience, knowledge of URAC/NCQA and federal program requirements, U.S. citizenship and favorable DoD background investigation for TRICARE support.
Outlook, Teams, Word, Excel, PowerPoint, SharePoint