Healthcare Salary in Phoenix, AZ

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only) Job Summary The Alternative Health Care Program Manager is responsible for managing the operational relationship between TriWest and its partners that offer alternative access points for care (e.g. telehealth, mobile care, etc.). The Program Manager will help to facilitate direction regarding network, communication, provider education and training, clinical quality, file exchange requirements (e.g. provider or eligibility files), claims integration and reporting. The Program Manager may assist with ensuring that the subcontractor fully understands and meets program requirements.Education & Experience Required: • Bachelor's degree in Business Administration, Finance or Health Care Administration or similar degree; OR equivalent experience • 3+ years' related experience with alternative health care as part of program management approach or as component in network management • Proven ability to execute across multiple locations and stakeholder groups • Experience working on and influencing teams to produce desired outcomes • Experience with data analysis, statistical analysis, process flow mapping and report design, including proficiency with database querying and the Microsoft Product Suite (specifically Word, Excel, PowerPoint, Project, and VISIO) Preferred: • MBA • Experience with quality programs (Six Sigma, Total Quality Management, Continuous Quality Improvement or other quality concepts)Key Responsibilities• Serves as one of the key points of contact to address program implementation issues, network management, provider education and communication needs and system integration • Manages relationship with the primary subcontractor and/or network partners related to network management and all related work streams (e.g. provider education) • Collaborates, and coordinates support the subcontractor may need such as program education materials • Determines the impact of government contract requirements and specific business initiatives on operations and communicates those impacts to primary subcontractor's stakeholders • Identifies and communicates opportunities for redefinition of operational and management processes based upon analyses of "lessons learned" in order to improve operations effectiveness and efficiency • Creates, manages and executes action plans, developed in conjunction with the primary subcontractor, to improve operations and adherence to contract standards • Communicates operational changes and training and program materials to primary subcontractor stakeholders for distribution to staff • Assists with special projects and other duties, as assigned by TriWest Senior LeadershipCompetenciesCommunication / People Skills: Clearly presents information through spoken or written communication; Effectively reads others and adapts communication patterns to multiple individual styles; Demonstrates ability to influence or persuade others in positive or negative circumstances; Ability to listen critically for relevant information; Clearly demonstrate respect for others Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required Independent Thinking / Self-Initiative: Critical thinker with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources Information Management: Ability to manage large amounts of complex information easily, communicates clearly, and draws sound conclusions High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment Organizational Skills: Detail-oriented; Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources Team-Building / Team Player: Ability to influence the actions and opinions of others in a positive direction and build group commitment; Adapt to different styles; Listen critically; collaborate Technical Skills: Advanced knowledge of Microsoft Word, Excel, and PowerPoint; Ability to function without direction to produce outcomes within timelines; Proficiency with project management skills, data analysis, and quality improvement concepts; Collaboration skills and team-oriented approach; Presentations and meeting facilitation skillsWorking ConditionsWorking Conditions: • Availability to work non-regular hours, including weekends, as required • Works within a standard office environment, with up to 50% travel • Extensive computer work with long periods of sittingCompany Overview Taking Care of Our Nation's Heroes. It's Who We Are. It's What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve! Our job is to make sure that America's heroes get connected to health care in the community. At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.BenefitsWe're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes: Medical, Dental and Vision Coverage Generous paid time off 401(k) Retirement Savings Plan (with matching) Short-term and long-term disability, basic life, and accidental death and dismemberment insurance Tuition reimbursement Paid volunteer time *Annual base salary for Colorado and Washington State residents: $99,000 - $110,000 depending on experience*Equal Employment OpportunityTriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

Overview The Solution Executive - CQS (Compliance, Quality and Safety) must have proven sales success selling CQS software solutions in healthcare and be energetic, hardworking, hands-on and self-motivated. The candidate will manage new business growth of the symplr portfolio within the assigned territory. This individual should demonstrate excellent strategic and critical thinking sales skills. The right candidate can expect to be rewarded for performance and successful results. This position can work from a remote location.Duties & Responsibilities A successful candidate will be one who is tactical in the hands-on execution of our enterprise sales strategy; one who can attain sales goals; and one who can contribute to enhancing sales processes. We work in a team selling environment. The successful candidate will have excellent communications skills, be able to work collaboratively with peers while developing and managing a healthy pipeline to deliver consistent results, and achieve monthly, quarterly and annual sales targets. The successful candidate will have experience selling software, preferably SaaS/Cloud software into enterprise accounts and in the healthcare market. This is a remote opportunity. Duties and Responsibilities: Manage sales planning and sales execution in assigned accounts/territory Manage a healthy pipeline of early, mid and late stage opportunities to drive consistent results Prospect for potential customers by using various tools and direct and indirect methods such as calls, email, face to face meetings, SalesForce, Linkedin, Definitive Healthcare and networking events Build strong relationships with prospects with a focus on cultivating strong relationships over time Establish an evergreen business plan by territory and develop comprehensive territory whitespace plans to achieve annual quota Identify prospect's pain points and business objectives and articulate the symplr value proposition effectively Lead client negotiations, and manage the contracting process by working with client and internal business and legal participants, develop executive relationships Meet or exceed Sales and Revenue targets monthly/quarterly/annually Coordinate prospecting activity within assigned accounts/territory and work closely with the business development team and marketing to execute Identify and attend relevant industry events to increase awareness and penetration Skills Required: 3+ years of experience selling CQS SaaS into healthcare Must live in, and have experience selling in the Northeast The ideal candidate possesses the highest levels of business acumen and possess the skills required to lead a strategic sales process Ability to demonstrate a relevant successful track record in sales Demonstrated proficiency with computer applications, computer-based sales tools, and SaaS business applications Ability to effectively influence and guide perspective clients Ability to understand and navigate through complex political environments and corporate structures The ability to effectively shift priorities and work at a rapid pace Proven relationship building skills required Excellent communication skills, including writing, articulating, listening, and questioning skills Must be willing to travel (Frequent travel required). Ability to travel to on site presentations and meetings for key opportunities, and coordinate trade shows or other marketing efforts Ability to effectively interface with all levels inside and outside the company, including senior management Ideally have contacts throughout the industry in various management levels in healthcare management. Skills Required Every organization has a culture, whether they mean to or not, so why not be intentional about it? Together, if we shape our intentions, actions, and interactions around a common, purposeful culture, we are able to quickly achieve more, attract others who help realize our goals, and thrive in our professional relationships. Strong leadership skills required to manage and attract top performers A self-starter with an entrepreneurial mindset who is motivated and will take ownership of your area of responsibility Experience in a fast-paced environment Able to engage both technical and business stakeholders Strong presence and credibility required to anchor symplr's initiatives Strong presentation skills Ability to effectively prioritize and manage team responsibilities Ability to articulate complex concepts clearly Extremely organized, detail-oriented and will demand excellence of themselves Strong competency in managing their time and activities and must possess a "can-do" perspective in their professional attitude MinUSD $100,000.00/Yr. MaxUSD $120,000.00/Yr.

Notes: No employers, only self corporation & W2 candidates.6+ years of IT experience with 3+ years working as Business Analyst.3+ years of experience working for Healthcare domain, especially Providers.3+ years of experience working for Data warehouse (DW), Analytics or Big Data projects.Working knowledge of SQL. Technical skills with Healthcare integration is preferred.Strong exposure to Software Testing tools like ALM (Quality Center), JIRAFamiliarity with Agile methodology of project execution

National Am Law 100 firm seeking a healthcare litigation attorney for their Los Angeles office. While the firm prefers a candidate local candidate, the right candidate can enjoy a remote arrangement if they are admitted to the California bar. The firm has consistently been recognized by Chambers USA, Legal 500, American Lawyer, and U.S. News/Best Law Firms. The attorney for this role will work with a tight-knit specialty litigation team focused on representing various types of entities within the healthcare space including providers, pharmaceuticals, hospitals, insurance providers, and more in matters pertaining to federal or state investigations and inquiries, and civil commercial matters. The firm pays competitively amongst it's Am Law peers and has a robust bonus program for high performing attorneys. Qualifications include: 3+ years of experience in healthcare litigation Admission to the California bar Excellent grades and writing skills Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records.Company Profile:Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.Learn more about Beacon Hill Staffing Group and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.beaconhillstaffing.com .We look forward to working with you.Beacon Hill. Employing the Future (TM)

At Mercer, our purpose is to make a positive difference in people's lives by helping advance their health, wealth, and careers. Mercer is seeking candidates for the Government Healthcare Actuary position. Our primary offices are located in Phoenix, Atlanta, DC, and Minneapolis.Government Healthcare ActuaryWe will count on you to:Serve as actuary on large, complex capitation rate setting and other actuarial projects.Under the direction of senior actuarial staff, support the design and implementation of rate structures and methodologies, and ensure consistency with federal regulations and actuarial standards.Support the development of rate setting assumptions that are built into actuarial models and inform the project teams on the impact of data and assumptions, and provide on-going review and guidance throughout the rate setting process.Collaborate with project teams to finalize rates and educate the clients on the impact of their policies on the data and rates.Participate in the drafting of project communications, including rate certification letters and presentations. When qualified, act as actuarial authority that signs rate certification letters and other statements of actuarial opinion under the supervision of senior actuarial staff.What is in it for you?Be on the cutting edge of health care reform. Mercer GHSC partners with states and the Federal government on implementing a wide variety of healthcare and human services issues, including actuarial, data/systems analysis, clinical, policy, pharmacy, operations, and procurement.On day one you'll be eligible for medical, dental, and vision care benefits in addition to a generous PTO package, as well as time off for community service.What you need to have:BA/BS degreeActuarial credentials (ASA or FSA, MAAA) strongly preferred. We may consider otherwise qualified candidates that are close to receiving actuarial credentials.3+ years minimum health actuarial experience, with Medicaid actuarial experience strongly preferredWhat makes you stand out:Medicaid actuarial experience (any state program, health insurer or Federal agency) or actuarial consulting experience is a plusExcellent interpersonal skills; strong oral and written communication skillsAbility to prioritize and handle multiple tasks in a demanding work environmentStrong critical thinking and analytical problem-solving skillsExperience related to health plan analysis or capitated rate development is preferred, but not requiredTo learn more about Mercer's GHSC practice, please visitwww.mercer-government.mercer.comMercer believes in building brighter futures by redefining the world of work, reshaping retirement and investment outcomes, and unlocking real health and well-being. Mercer's more than 25,000 employees are based in 44 countries and the firm operates in over 130 countries. Mercer is a business of Marsh & McLennan (NYSE: MMC), the world's leading professional services firm in the areas of risk, strategy and people, with 76,000 colleagues and annual revenue of $17 billion. Through its market-leading businesses including Marsh, Guy Carpenter and Oliver Wyman, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit https://www.me.mercer.com/. Follow Mercer on Twitter @Mercer.Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one "anchor day" per week on which their full team will be together in person.

At Mercer, our purpose is to make a positive difference in people's lives by helping advance their health, wealth, and careers. Mercer is seeking candidates for the Government Healthcare Actuary position. Our primary offices are located in Phoenix, Atlanta, DC, and Minneapolis.Government Healthcare Actuarial Consultant We will count on you to:Serve as actuary and project leader, working directly with actuarial and data analysts, clinicians and health policy consultants, on large, complex capitation rate setting and other actuarial projects.In conjunction with the other project leaders, work with the client to define and manage the scope of the project, serve as an expert on rate structures and methodologies, and ensure consistency with federal regulations and actuarial standards.Oversee the development of rate setting assumptions that are built into actuarial models and inform client and project teams on the impact of data and assumptions, andprovide on-going review and guidance throughout the rate setting process.Collaborate with client and project teams to finalize rates and educate clients on the impact of their policies on the data and rates.Work with Mercer actuaries, clinicians, and health policy consultants to support the design and implementation of innovative and comprehensive solutions to emerging and/or unique challenges faced by clients.Oversee the drafting of project communications, including rate certification letters and presentations, and act as an actuarial authority that signs rate certification letters and other statements of actuarial opinion.Work with project leaders to identify growth and development opportunities for junior actuaries and actuarial students on project teams. Provide guidance, oversight and mentoring to junior actuarial staff as needed.What is in it for you?Be on the cutting edge of health care reform. Mercer GHSC partners with states and the Federal government on implementing a wide variety of healthcare and human services issues, including actuarial, data/systems analysis, clinical, policy, pharmacy, operations, and procurement.On day one you'll be eligible for medical, dental, and vision care benefits in addition to a generous PTO package, as well as time off for community service.What you need to have:BA/BS degreeActuarial credentials (ASA or FSA, MAAA) strongly preferred.5+ years minimum health actuarial experience, with 3+ Medicaid actuarial experienceWhat makes you stand out:Medicaid actuarial experience spanning multiple states, programs, health insurers or Federal agency and/or actuarial consulting experienceExperience leading large teams and/or large, complex projectsExcellent interpersonal skills; strong oral and written communication skillsAbility to prioritize and handle multiple tasks in a demanding work environmentStrong critical thinking and analytical problem-solving skillsExperience related to health plan analysis or capitated rate development is preferred, but not requiredTo learn more about Mercer's GHSC practice, please visitwww.mercer-government.mercer.comMercer believes in building brighter futures by redefining the world of work, reshaping retirement and investment outcomes, and unlocking real health and well-being. Mercer's more than 25,000 employees are based in 44 countries and the firm operates in over 130 countries. Mercer is a business of Marsh & McLennan (NYSE: MMC), the world's leading professional services firm in the areas of risk, strategy and people, with 76,000 colleagues and annual revenue of $17 billion. Through its market-leading businesses including Marsh, Guy Carpenter and Oliver Wyman, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit https://www.me.mercer.com/. Follow Mercer on Twitter @Mercer.Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one "anchor day" per week on which their full team will be together in person.

Our client, a highly-regarded national medical association based in the Research Triangle Park, NC area, is actively recruiting for a skilled, knowledgeable and self-directedprofessional to assume key role on its Health Policy/Member Relations team.This association, which supports medical professionals in the Cardiovascular space, provides education, advocacy, innovation and research services to its members. This would include guidance, information and strategy regarding healthcare and reimbursement issues as well as lobbying and other advocacy on behalf of the industry.This individual will support the Director of Advocacy in the delivery of the association's evolving healthcare policy/advocacy program. They will work with members to optimize payment and practice management needs. They will work in support of the members by monitoring healthcare trends and government policies related to their specialty.It is a high-impact role, and finding the right candidate is a top priority at this time.Key Things to Note:This position is responsible for learning, leveraging, and communicating best practices and trends in cardiovascular health including regulatory/compliance matters. Seek a skilled writer who will create communication on policy-/advocacy-related matters.This position will routinely interact with their high expectations membership (e.g., physicians, lab directors, practice leadership) as well as key opinion leaders in the field. Seek a candidate with exceptional verbal communication skills.This position will be heavily involved in data analytics, including survey administration and results. Seek candidate who can review data and summarize key points that will inform the organization and its constituency on emerging issues. Some experience in survey administration would be a plus.This individual will juggle multiple projects and deadlines. Targeted candidate will bring exceptional project coordination skills and the ability to assess priorities to ensure deliverables are met.This is a direct hire role. The position is remote, but must be commutable to the RTP offices for meetings, training, etc. Client is targeting candidates who reside in NC, SC, VA, DC, MD, GA, TN. Other occasional travel will also be expected.Selected Duties:Provide analysis and interpretation of payment and professional practice regulations and develop responses via comment letters, meetings, and other appropriate means.As a member of the Advocacy Committee, identify and develop strategies to meet current and future payment/practice management needs.Monitor the Intersocietal Accreditation Commission for related policy changes and coordinate organizational responses.Coordinate and provide communications team with content for member alerts on emerging advocacy issues.Research and provide advice on workplace and health care finance issues. Be the spokesperson for practice management issues with internal and external bodies.Manage help desk for advocacy and practice management questions.Coordinate volunteer-based projects and task forces relating to practice management issues.Manage salary, workforce surveys and related activities.Manage advocacy- related webinars/seminars.Targeted candidate will offer a BA/BS (advanced degree in healthcare administration, public health, or related field preferred) and 3+ years of experience working with advocacy, communications, health policy or regulatory/compliance-related tasks. Experience working in the healthcare association space, including working with volunteers, is strongly preferred.Other priorities include:Outstanding interpersonal and communication skills, including public speaking.Demonstrated ability to communicate effectively in written materials and promotions.Facility with survey mechanisms and reporting. Proven ability to process and manage survey data.Analytical ability to review data and summarize key points.Understanding of health policy/issues.Superb project management skills, including the ability to simultaneously juggle numerous projects.A self-motivated worker with excellent attention to detail.Competence in Windows Office 365 software, database programs, and online applications.Finally, this is a dynamic, collaborative, and mission-driven setting. Seek a self-directed and extremely competent professional who gets things done.Please forward resume for prompt consideration. NC, DC or near NC candidates only. Position will pay in the $60s to $70 annually.

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only)Veterans, Reservists, Guardsmen and military family members are encouraged to apply!Job SummaryThis position is under the general guidance of the Manager, Program Integrity and reports directly to the Supervisor, PI Specialist. The PI Specialist is responsible for the identification, analysis, case developmThis position is under the general guidance of the Manager, Program Integrity and reports directly to the Supervisor, PI Specialist. The PI Specialist is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA) and the Healthcare Finance Administration (HCFA); requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s). Complies with the Veterans Affairs Community Care Network (CCN) contract, Defense Health Agency TRICARE contract, and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, TRICARE beneficiaries, providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals.ent, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA) and the Healthcare Finance Administration (HCFA); requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s). Complies with the Veterans Affairs Community Care Network (CCN) contract, Defense Health Agency TRICARE contract, and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, TRICARE beneficiaries, providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals.Education & ExperienceRequired o 2 years experience in fraud, waste and abuse investigations, or equivalent claim auditing experience o Experience with data analysis techniques, to include Excel and/or SQL expressions o High School Diploma or GED required o Experience with quality review standards and healthcare claims analysis techniques o Knowledge of medical billing regulations and practices, as well as standard healthcare benefits and exclusions Preferred o Knowledge of current trends in healthcare fraud, waste and abuse o Knowledge of CMS benefits and policies o Knowledge of Facets o Certified Coder (CPC, CPC-P, CCA, CCS-P), AHFI, or other related certification o Experience with IBM's Fraud and Abuse Management System (FAMS) and Case Manager Solutions o Experience with PeopleSoft and MS Office SuiteKey Responsibilitieso Independently researches FWA issues and effectively employs investigative resources/techniques in achieving projected PI performance goals and outcomes, requiring minimal direction o Maintains the confidentially and non-discoverability of all fraud and abuse, quality assurance, quality management, and risk management issues. o Reconciles special, unresolved issues associated with beneficiary and provider inquires o Facilitates and supports Program Integrity goals, objectives, and contract compliance o Readily accesses and interprets VA, TRICARE, and TriWest guidelines, policies and procedures o Effectively utilizes appropriate data systems as provided and required by TriWest to identify, research, document and track fraud and abuse issues and activities. o Participates in and/or completes VA or TRICARE directed leads, audits, investigations, data collection, and medical record reviews for fraud and abuse case development. o Proactively identifies and researches potential fraud and abuse issues o Performs as a witness in court as requested o Researches and investigates health care fraud issues, claims data, medical records as they relate to potential fraud and abuse cases (i.e.; problem provider issues) o Prepares and submits medical records for PI clinical review as appropriate o Ensures accuracy, completeness, and timely submission of all required leads, reports, audits, and case development activities and documents o Coordinates/liaises with TriWest departments, PGBA POC's, and government agencies in researching, determining, and reporting FWA issues. o Participates in and contributes to PI education and training for beneficiaries, providers, subcontractor, and TriWest interdepartmental personnel regarding fraud and abuse o Assists supervisor in the preparation and compilation of monthly, quarterly, semiannual, and special reports as required o Participates in system enhancements for reporting fraud and abuse activities o Facilitates the development of Program Integrity materials for staff, provider and beneficiary education and training as well as assist other departments with educational requests . o Facilitates the development of Program Integrity materials for provider seminars, provider newsletter, and quarterly bulletins o Assists in the development of quality studies as directed by TriWest Medical Directors o Assists supervisor with the annual review of PI policies and desk procedures o Demonstrates effective use of documentation systems for communication, tracking, trending, and reporting purposes o Research and prepare appropriate and timely responses to beneficiaries, provider and congressional compliant issues referred to Program Integrity by other company departments. o Interfaces with all levels of TriWest employees and maintains effective working relationships while adhering to all customer service goals and guidelines. o Demonstrates flexibility and adaptability towards achieving PI departmental performance/production goals and objectives o Routinely processes recoupment requests, live claims, and performs other duties as assigned. Attends and participates in continuous training opportunities in current schemes and trends related to FWA o Participates in and contributes to FWA information-sharing resources, task forces, and joint investigative efforts Regular and reliable attendance is required.CompetenciesTechnical Skills Knowledge with CPT4, ICD-10-CM, HCPCS, DRG and Revenue Code coding conventions. Knowledge of standard benefit coverage policies and exclusions, including National and Local Coverage Determinations. Knowledge of standard healthcare billing regulations and practices. Problem Solving / Analysis Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues. Organizational Skills Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.Working ConditionsWorking Conditions: • Availability to work any shift • This is a remote position, with minimal travel • Extensive computer work with prolonged sittingCompany Overview Taking Care of Our Nation's Heroes. It's Who We Are. It's What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve! Our job is to make sure that America's heroes get connected to health care in the community. At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.DoD StatementOur Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.BenefitsWe're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes: Medical, Dental and Vision Coverage Generous paid time off 401(k) Retirement Savings Plan (with matching) Short-term and long-term disability, basic life, and accidental death and dismemberment insurance Tuition reimbursement Paid volunteer time *Annual base salary for Colorado, Hawaii and Washington State residents: $58,000- 75,000 depending on experience*Equal Employment OpportunityTriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

A leading dental health provider is looking to bring on a Senior Counsel. In this position, you will work closely with senior management, advising on contracts, healthcare regulations, corporate governance, M&A, compliance, and litigation/risk management.RequirementsJD from an accredited law school.5+ years of healthcare legal experience, in-house experience preferred.This position is remote with some travel to Atlanta, Georgia.

Position: Financial AnalystLocation: 100% Remote - Midwest and West Coast candidates only pleaseSalary: $50-70 per hour W2 employmentDuration: 6 monthsMust have EHR System experienceJob Summary:Provides financial analysis and management planning support. Reviews, reconciles and analyzes data to insure financial integrity of information reported and identification of trends. Monitor and reconcile statements and participate in the reconciliation of accounts. Provides independent analysis to leadership regarding financial results and identification of potential improvements.Job Requirements:Education and Work Experience:• Associate's/Technical Degree in accounting, finance, business administration or equivalent combination of education/related experience: Required• Bachelor's Degree in accounting, finance, business administration or equivalent combination of education/related experience: Preferred• Three years' relevant experience: Preferred• One year's experience in accounting or finance: PreferredLicenses/Certifications:• Certified Public Accountant (CPA): PreferredEssential Functions:• Develops and maintains financial analysis tools and reporting, daily productivity dashboards, and trend and forecast reporting's. Participates in the monthly accounting close functions, annual budgeting process and balance sheet reconciliations.• Provides support with contract and reimbursement modeling. Assists in yearly budgeting through development of supporting data, compilation of information and important to budgeting system.• Monitors reports to ensure data quality. Processes, enhances, and acquires technical skills to work with database and business intelligence systems.• Performs other job-related duties as assigned.