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Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County.
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Credentialing Time Frame: Active Medicaid - 2 weeks, New Medicaid enrollment Provider 90 - 120 days. This facility is seeking a Pediatric Dentist for locum tenens support as they look to fill a current need.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and Network Performance Standards. Accountable for working with our strategic provider partners to develop innovative value-based solutions to meet total cost and quality goals for our Medicaid businesses.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Federally Qualified Health Center (FQHC) Medicaid and Medicare billing experience is required. Under the supervision of the Director of Finance, the Billing Manager is responsible for the day-to-day operations of billing services and provider enrollment.
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Certified Provider Credentialing Specialist (CPCS) certificate preferred or willingness to sit for CPCS within one (1) year of hire. One to three years of current provider credentialing experience required.
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Minimum of one year paralegal/legal assistant experience, preferably in healthcare environment or experience in Medicare or Medicaid provider enrollment or private payer enrollment/credentialing.
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Assist with Pharmacy Complaints and Grievances as well as Medicaid Provider Enrollment. Experience with Medicare Part D and Medicaid. Assist with Network Strategies- Provider Relations projects and with training to other staff members.
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Minimum of 3 years recent Managed Care experience in Provider Relations, Network Operations, and/or Network Management. The Senior Manager of Provider Relations manages a team of Provider/Network Relations representatives (approximately 4) and reports to the local Lead Director.
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Minimum of 5 to 7 years’ experience in Provider Relations; experience in Medicaid servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.
$43,700 - $102,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Enroll provider in Medicare/Medicaid as prescribed by each program requirements. Essential Functions, Duties, and Responsibilities Prepare and maintain Zufall credentialing files and reports for all individual providers including maintenance of credentialing software, provider rosters and spreadsheets to comply with group delegation requirements.
$20.5 - $27.65 an hourExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Performs other related tasks as directed by the VP Provider Network Operations & Credentialing Director. Data entry provider information in the credentialing and other pertinent databases.
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Position Summary:The Lead Director will be part of the Aetna Network organization and have oversight and monitoring of Medicaid network compliance requirements, focused first on Medicaid credentialing and provider data tasks.
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Wisconsin Medicaid and HMO credentialed provider (credentialing can be completed by CSD Director of Operations). Integrates appropriate patient dental hygiene care with CSD dentists and other healthcare professionals involved in the patient’s health care management.
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Experience in other provider related healthcare departments such as credentialing, provider relations or contracting preferred. Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan.
Full-timeRemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Certification by the National Association Medical Staff Services (NAMSS) as a Certified Professional in Medical Services Management (CPMSM) or a Certified Provider Credentialing Specialist (CPCS.
ExpandApply NowActive JobUpdated 5 days ago
provider credentialing medicaid jobs
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