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Providence St. Joseph Health
Renton, WA, United States
Description (This position will be in person for the first 90 days. After 90 days, may be eligible to work from home, 1-2 times a week) Supports and works collaboratively with internal and external groups to support our commitment to high-quality, value-based care. The Population Health Coordinator operates in a highly autonomous manner, utilizes a
Job Source: Providence St. Joseph HealthProvidence St. Joseph Health
Renton, WA, United States
Description Adjudicates claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions. Adjusts complex claims for advanced processing needs. Responds to Customer Service Requests and resolves problem claim situations. Providence caregivers are not simply valued - they're invaluable. Join our t
Job Source: Providence St. Joseph HealthProvidence Health & Services
Seattle, WA, United States
Description Coordinates care for Pacific Medical Centers' Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs, and coordinates the entire spectrum of care for patient throughout a variety of settings, both inpatient and outpatient. This position assists physic
Job Source: Providence Health & ServicesPacific Medical Centers
Seattle, WA, United States
Search for City, State, Country, Zip Code Care Manager RN - USFHP | Pacific Medical Center Jobs Description Coordinates care for Pacific Medical Centers' Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs, and coordinates the entire spectrum of care for patie
Job Source: Pacific Medical CentersProvidence Health & Service
Seattle, WA, United States
Job Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of chang
Job Source: Providence Health & ServiceProvidence Health & Service
Seattle, WA, United States
Job Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of chang
Job Source: Providence Health & ServicePacific Medical Centers
Seattle, WA, United States
Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of changes i
Job Source: Pacific Medical CentersProvidence Health & Services
Seattle, WA, United States
Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of changes i
Job Source: Providence Health & ServicesRenton, WA, United States
Description Responsible for maintaining and updating the GE/Centricity/IDX Managed Care Application (MCA) module for US Family Health Plan's managed care line of business: builds fee schedules, provider and vendor dictionary entries, and plan benefits and exclusions. Assists with health plan utilization management reporting for the organization. Responsible for ensuring that optimal payment methodology is in place for payments from US Family Health Plan to vendors and other providers. Responsible for all reports and data transfers to the Department of Defense and its contractors. Provides support for the quality management program. Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Bachelor's Degree: Related field or Equivalent experience in Health Care Business Administration as required by URAC Four years: Minimum of four years' experience in managed care operations or large group practice setting. Microsoft SQL Server experience Must have knowledge of and experience in coding with both CPT and ICD-9 and ICD-10. Must possess an understanding of financial/administration/clinical business functions and the interfaces/relationships between applications in healthcare. Preferred Qualifications: Experience with Access and reporting from a warehouse type database. Experience with HEDIS reporting desired. Experience with GE/Centricity/IDX healthcare software application desired. Clinic setting operations experience highly desirable as complementary experience to the above. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for more information about our Benefits and Rewards. Requsition ID: 269684 Company: Pacific Medical Jobs Job Category: General Operations Job Function: Operations Job Schedule: Full time Job Shift: Career Track: Business Professional Department: 3060 WA USFHP Address: WA Seattle 1226 S Judkins St Work Location: PACMED Q5-Seattle Pay Range: $37.29 - $55.94 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for
Email Alert for Business Analyst - USFHP jobs in Renton, WA, United States
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