-
Senior Front-End Web Developer
5 days ago
Presbyterian Healthcare Services Albuquerque, United States Full timeOverview: · Now hiring a Senior Senior PL/SQL Developer · Summary: · Formulates and defines system scope and objectives based on user needs. Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time, and form ...
-
Utilization Management Coordinator
2 weeks ago
HCSC Albuquerque, United States Full timeAt HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. · Come join us and be part of a purpos ...
-
Human Resources Manager
1 week ago
Honeywell Albuquerque, United StatesSummary · This role will lead HR strategies with cross-functional teams and leaders to broker HR services and actively engage in talent acquisition, organizational development, talent management, coaching and direct employee interaction and employee relations issues. This role wi ...
-
Human Resources Manager
5 days ago
Honeywell Albuquerque, United StatesSummary · This role will lead HR strategies with cross-functional teams and leaders to broker HR services and actively engage in talent acquisition, organizational development, talent management, coaching and direct employee interaction and employee relations issues. This role wi ...
-
Sr Project Manager
4 weeks ago
Honeywell Albuquerque, United States Full timeSummary · Leads moderately complex Program(s), Project(s), and/or strategic business process development/execution. Acts as primary project manager for one or more specific weapons programs and/or reimbursable products/services. Represents Program Management function for assigned ...
-
Sr Logistics Specialist
3 weeks ago
Honeywell Albuquerque, United StatesSummary · Performs as team/project leader for key operational program components and serves as the focal point for equipment management, field deployment operations, program requirements implementation and reporting. Establishes and maintains effective relationships between NNSA ...
-
Senior Java PL/SQL Developer
1 week ago
Presbyterian Healthcare Services Albuquerque, United StatesOverview: · Now hiring Senior Java PL/SQL Developer - Remote Eligible · Formulates and defines system scope and objectives based on user needs. Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time, and fo ...
-
Hospice Sales Consultant/Care Navigator
2 weeks ago
Jet Health, Inc. New Mexico, United StatesCompany Description · Jet Health, Inc. is a provider of skilled home health, hospice, personal care, and companion services. Founded in April 2016, Jet Health is focused on building a national platform through organic growth, strategic acquisitions, and de novo build-outs in targ ...
-
Program Manager for Prison Programs
2 weeks ago
University Of New Mexico Albuquerque, United StatesProgram Manager · Requisition ID req29069 Working Title Program Manager for Prison Programs Position Grade 13 Position Summary · The University of New Mexico's Project ECHO is seeking a Program Manager to join our New Mexico Peer Education (NMPEP) Team, responsible for overseeing ...
-
PL/SQL and JAVA
3 days ago
Presbyterian Healthcare Services Albuquerque, United StatesOverview: · Now hiring PL/SQL and JAVA (Spring-Boot) Developer · Formulates and defines system scope and objectives through research and fact-finding to develop or modify moderately complex information systems. Prepares detailed specifications from which programs will be writte ...
-
Senior Java PL/SQL Developer
2 weeks ago
Presbyterian Healthcare Services Albuquerque, NM, United StatesNow hiring Senior Java PL/SQL Developer - Remote Eligible · Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time, and form of desired results. Competent to work at the highest technical level of all phas ...
-
Medicaid Application Coordinator
3 weeks ago
Genesis Healthcare Services Albuquerque, United StatesThis is a remote position with some travel to centers in the market. The Medicaid Liaison will provide onsite or remote support to complete the financial and clinical Medicaid eligibility processes in one or more skilled nursing centers (SNFs) with a Business Office vacancy. In a ...
-
Associate/Sr. Associate Athletics Director
23 hours ago
University of New Mexico Albuquerque, United StatesDiversity Program Director · Requisition ID · req28939 · Working Title · Associate/Sr. Associate Athletics Director - DEI & Student-Athlete Development · Position Grade · 15 · Position Summary · The Associate or Senior Associate Athletics Director - DEI and Student-Athlet ...
-
Admin Assistant to Exec Dir
2 weeks ago
University Of New Mexico Albuquerque, United StatesAdmin Assistant to Exec Dir · Requisition ID req29271 Working Title Admin Assistant to Exec Dir Position Grade 10 Position Summary · The Department of Dental Medicine has an exciting opportunity for an experienced full-time Admin Assistant to the Executive Director. As an importa ...
-
Clinical Support Specialist
2 weeks ago
MediTelecare Albuquerque, United StatesJob Description · Job DescriptionPOSITION SUMMARY: · The Clinical Support Specialist ("CSS") role is designed to provide both onsite/in-person clinical facilitation and remote administrative duties. In person, a CSS works with a clinician to facilitate care visits for patients. R ...
-
Medicaid Application Coordinator
4 weeks ago
Genesis Healthcare Services Albuquerque, United StatesThis is a remote position with some travel to centers in the market. The Medicaid Liaison will provide onsite or remote support to complete the financial and clinical Medicaid eligibility processes in one or more skilled nursing centers (SNFs) with a Business Office vacancy. In a ...
-
Product Manager- REMOTE
23 hours ago
Prime Therapeutics Albuquerque, United StatesOur work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.Job Posting TitleProduct Manager- REMOTE /Medical Specialty PharmacyJob DescriptionThe Product Manager is ...
-
NICU Social Worker
4 weeks ago
University Of New Mexico Albuquerque, United StatesCounselor/Social Worker · Requisition ID req28296 Working Title NICU Social Worker Position Grade 13 Position Summary · The Developmental Care Program Department of Pediatrics, Neonatology Division is seeking a full-time social worker to join our team. The interdisciplinary Devel ...
-
Nurse/Clinical Research Coord
2 weeks ago
University Of New Mexico Albuquerque, United States OTHERNurse/Clinical Research Coord · Requisition ID req28451 Working Title Nurse/Clinical Research Coord Position Grade 15 Position Summary · The Division of Neonatology is recruiting for a part time (0.6) Nurse/Clinical Research Coordinator. This position involves completion of dutie ...
-
Medicaid Application Coordinator
1 day ago
Genesis Healthcare Services Albuquerque, United StatesThis is a remote position with some travel to centers in the market. · The Medicaid Liaison will provide onsite or remote support to complete the financial and clinical Medicaid eligibility processes in one or more skilled nursing centers (SNFs) with a Business Office vacancy. In ...
Community Liaison- Remote - Albuquerque, NM, United States - Molina Healthcare
Description
Molina Healthcare is hiring in New Mexico for several Billing & Claims, Tribal Liaisons .These roles are specifically responsible for working with tribal entities regarding billing and claims support and resolution activities.
Highly qualified candidates will have strong communication skills, excellent Microsoft Office product knowledge, and experience with Native American provider relationship management.
These roles are remote, candidate must reside in New Mexico, as there may need to travel within the state according to business needs.
Strong claims knowledge and IHS is required.Responsible for continuous quality improvements regarding member engagement and member retention. Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials.
Assists Molina Healthcare in promoting Native American's access to healthcare coverage and educates communities about the general and value added services provided by Molina Healthcare.
Responsible for building and maintaining relationships with tribal community leaders, community-based organizations and providers within tribal lands and reservations through a combination of direct and indirect outreach and engagement activities directed toward building enrollment for all Health Plan lines of business.
Establishes formal working relationships with and acts as a central point of contact to the Indian Health Services (IHS) facilities and tribal 638 facilities.
As requested, helps support Molina Healthcare's relationship with IHS and tribal 638 facilities and establishes relationships with tribal employers.Develops liaison engagement strategy to maximize growth opportunities for the Health Plan.
Establishes and maintains relationships with assigned providers in tribal communities including Provider outreached (Indian Health Services and 638 Clinics).
Achieves net growth goals by assigned territory; Develops community and school outreach strategies including school-based engagement with key tribal schools; Serves as primary point of contact to the Native American Community, and other representatives as appropriate.
Holds semi-annual meetings with Native American representatives from around the State that represent geographic and member diversity.Makes documented efforts to contract with the appropriate urban Indian clinics, Tribally owned health centers, and IHS facilities for the provision of medically necessary services.
Ensures that translation services are reasonably available when needed, both in providers' offices and in contacts with the contractor.
Ensures appropriate medical transportation for Native American members residing in rural and remote areas for members.Ensures that culturally appropriate materials are available to Native Americans.
In-state travel required.
Specialized skills such as claims or billing
Bachelor's Degree preferred
Previous healthcare marketing and/or grassroots/community outreach experience
Preferred Experience:
Key Words:
Billing, Claims, Reconcile, IHS, Indian Health Services, Tribal Liaison, Medicaid, MCO, Managed Care, Tribal, Value Added, Community, Tribal 638, Tribal Governments, TCBOs, HSD/MAD, Claims Examiner, Auditor, Claims Processor,
#Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
