NewPhysician Coding Auditor Ensemble Health PartnersPhysician Coding AuditorBrandon, MSRemote$57,400–$99,000The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Educating - Assesses the educational needs of coding staff and providers that are contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or researches educational resources to meet those needs.
NewCoder Quality Auditor Ensemble Health PartnersCoder Quality AuditorBrandon, MSRemote$57,400–$99,000Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW. Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts.
Physician Coding Analyst University of Mississippi Medical CenterPhysician Coding AnalystClinton, MSEnvironmental and Physical Demands: Requires no exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, frequent activities subject to significant volume changes of a seasonal/clinical nature, constant work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, occasional climbing, no crawling, occasional crouching/stooping, occasional driving, no kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking. One of the following medical coding certifications from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred post-hire within one (1) year: Registered Health Information Management Technician (RHIT).
General Practice Care - Associate Veterinarian - Jackson , {State_Code UsvtaGeneral Practice Care - Associate Veterinarian - Jackson , {State_CodeJackson, MississippiAn exceptional veterinary hospital, with a dedicated team, is seeking an Associate Veterinarian to provide superior patient and client care to members of its community. of rewards and benefits that our partners may offer, but the specific details surrounding each hospital’s total rewards package will be provided by the hiring manager during each interview process.
NewMedical Coder-Outpatient University of Mississippi Medical CenterMedical Coder-OutpatientJackson, MSEnvironmental and Physical Demands: Requires no exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, frequent activities subject to significant volume changes of a seasonal/clinical nature, constant work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, occasional climbing, no crawling, occasional crouching/stooping, occasional driving, no kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking. One of the following medical coding certifications from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred post-hire within one (1) year: Registered Health Information Management Technician (RHIT).
Medical Billing Specialist MDB Health Services careersMedical Billing SpecialistMississippiGenerally, duties include core revenue cycle functions such as, billing, claims filing, data entry, charge entry, insurance follow up, denial management, payment posting, billing records review, and customer service. The position is located at our company headquarters in Flowood, MS, billing for multiple locations.
Patient Financial Services Rep I - (Ambulatory Billing) West Tennessee Healthcare System LLCPatient Financial Services Rep I - (Ambulatory Billing)Jackson, MSDemonstrate proficiency in at least one or more of the following: Billing processes of at least one specific payer's billing and collection practices; Account Follow-Up processes of at least one specific payer's billing and collection practices including credit balance resolution; Denials management processes to include denial/claim research, filing appeals, and resolution of denied patient accounts; Payment Posting and Cash Reconciliation processes; Self-Pay Processing / Customer Service including qualifying accounts for charity care, bad debt, and credit balance resolution. ESSENTIAL JOB FUNCTIONS: Reviews institutional and professional claims for appropriate use of procedure, modifiers and diagnostic codes to ensure maximum reimbursement using electronic billing systems and in-house computer systems to edit, modify, or change information on the UB04 and CMS-1500 claim forms for Medicare, Medicare Advantage, Medicaid/TennCare, BCBS, Commercial, and/or other third-party payers.
Compliance Educator - Office of Integrity & Compliance University of Mississippi Medical CenterCompliance Educator - Office of Integrity & ComplianceJackson, MSPhysical and Environmental Demands: Requires occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, constant work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching/stooping, occasional driving, constant sitting, frequent standing, occasional twisting, and frequent walking. Time Type: Full time FLSA Designation/Job Exempt: Yes Pay Class: Salary FTE %: 100 Work Shift: Day Benefits Eligibility: Grant Funded: No Job Posting Date: 02/13/2026 Job Closing Date (open until filled if no date specified):
Compliance Analyst - Office of Integrity & Compliance University of Mississippi Medical CenterCompliance Analyst - Office of Integrity & ComplianceJackson, MSPhysical and Environmental Demands: Requires occasional working hours significantly beyond regularly scheduled hours, occasional traveling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, constant work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching/stooping, occasional driving, constant sitting, occasional standing, occasional twisting, and occasional walking. Preferred Qualifications: Certification from American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), Health Care Compliance Association (HCCA), Association of Clinical Research Professionals (ACRP), and/or Society of Clinical Research Professionals (SoCRA).
Medical Office Assistant- Dermatology-Face and Skin Center University of Mississippi Medical CenterMedical Office Assistant- Dermatology-Face and Skin CenterRidgeland, MSHigh School Diploma/GED required and completion of a formal medical office assistant or equivalent training program, such as but not limited to: Certified Medical Assistant, Emergency Medical Technician, or Licensed Practical Nurse with no clinic experience or, High School Diploma/GED required and two (2) years experience in a healthcare setting. Checks-in patients, assists with patient histories, checks accuracy of patient information, prepares charts, may be called upon to chaperone or assist provider during examinations and other patient care activities, performs billing and other general medical office procedures in accordance with established protocols of a particular clinic.
Care Management Associate, Engagement Hub CVS Health CorpCare Management Associate, Engagement HubMS$18.50–$31.72 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Account Executive - Hospice UnitedHealth Group IncAccount Executive - HospiceJackson, MSPrimary Responsibilities Build and maintain relationships with target referral sources to execute the bring care to more people growth strategy Implement manage and document consistent sales activities with multiple contacts in each referral source Seek to better understand the needs of customers to provide customized solutions and earn newcontinued referrals Expand the healthcare communitys use of our services by supporting knowledge and awareness of our solutions Serve as a liaison between our referral sources community our patientsfamilies facing end of life care and our agencies. Clinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S.
Senior Clinical Compliance Auditor Blue Cross & Blue Shield of MississippiSenior Clinical Compliance AuditorFlowood, MississippiJob Summary: The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant information for clinical and coding assessment and validation of related billing of services provided to Blue Cross Blue Shield Customers.
Clinical Documentation Improvement Specialist University of Mississippi Medical CenterClinical Documentation Improvement SpecialistJackson, MSPhysical and Environmental Demands Requires no exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, frequent activities subject to significant volume changes of a seasonal/clinical nature, constant work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, occasional climbing, no crawling, occasional crouching/stooping, occasional driving, no kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking (occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more). Certifications, Licenses, or Registration required: Valid RN license, CCDS (Certified Clinical Documentation Specialist) Preferred Qualifications: Three (3) years of related hospital-based clinical documentation experience Knowledge, Skills & Abilities Knowledge, Skills, and Abilities: Demonstrates knowledge of evidence-based clinical guidelines across diverse conditions and age groups, as well as resource and utilization management, cost, and quality issues.
Medical Director MPO CVS Health CorpMedical Director MPOMS$174,070–$374,920 / yearIn this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. Additional responsibilities may include: Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services.
Account Executive - Heart of Hospice UnitedHealth Group IncAccount Executive - Heart of HospiceJackson, MSClinical › Corporate and business operations › Customer and support services › Early careers › Sales and account management › Technology and data › Physicians › Advanced practice clinicians › Pharmacy › Behavioral health › Nursing › Medical coding › Clinical support › U.S. › Ireland & UK › India › Philippines › Culture of Belonging › Employee Benefits › Blog. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Fraud Waste and Abuse - Sr. Analyst CVS Health CorpFraud Waste and Abuse - Sr. AnalystMS$46,988–$112,200 / yearActivities include reviewing billing activity for state agency referrals, assisting in the investigation and triage of FWA complaints, coordination with other departments and assist in prevention activities including training of internal staff and internal departments. Analyst, Fraud, Waste, and Abuse (FWA) will assist in detecting, investigating, remediating and referring to state regulatory agencies incidents of FWA arising in connection with medical, behavioral, transportation, and other healthcare services.
Clinical Documentation Specialist II - Revenue Cycle University of Mississippi Medical CenterClinical Documentation Specialist II - Revenue CycleClinton, MSRequires no exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, frequent activities subject to significant volume changes of a seasonal/clinical nature, constant work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to 100 pounds, no lifting/carrying 100 pounds or more, occasional climbing, no crawling, occasional crouching/stooping, occasional driving, no kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking. To support and review the inpatient medical record in order to facilitate improvement in overall quality, completeness, clinical severity, and accuracy of inpatient clinical documentation for DRG based or APR based payor population for specific departments or areas.
Field Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN) Vertex PharmaceuticalsField Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN)MississippiCompliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.
NewMedical Claim Analyst CVS Health CorpMedical Claim AnalystMS$18.50–$35.29 / hourThis function includes, but is not limited to the following: Review provider re-submissions of ClaimsXten, Clinical Validation, Prospective Claim Accuracy, Novologix and DRG claims and resolve or prepare them for review by an Aetna clinician. The Medical Claim Analyst will be part of the Provider Coding and Reimbursement (PCR) team who reviews provider coding and reimbursement denial disputes from providers.
Specialist-Clinical Documentation III RN Baptist Memorial Health Care CorpSpecialist-Clinical Documentation III RNJackson, MSSpecialist-Clinical Documentation III RN Job ID 39051 Job Category: Administrative Non Clinical Support Work Type: Full Time Work Schedule: Days Department: Clinical Documentation Integrity Facility: BMHCC System Services Location: Jonesboro, AR. • Must demonstrate knowledge of the principles of disease denitions and natural history possess the ability to assess data reective of the patients clinical status interpret the appropriate information needed to identify each patients acuity and severity of illness.
NewPatient Account Representative - Pain Management Clinic University of Mississippi Medical CenterPatient Account Representative - Pain Management ClinicJackson, MSPhysical and Environmental Demands: Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent, standing, occasional twisting, and frequent walking. Basic knowledge of medical terminology, Basic knowledge of revenue cycle functions, Ability to pay attention to detail, Ability to maintain a professional appearance and attitude, Ability to read, write, type, and follow oral and written directions, Ability to work independently to effectively and efficiently perform assigned duties, and good interpersonal communication and organizational skills, and proven ability to work effectively with others.
Patient Account Representative University of Mississippi Medical CenterPatient Account RepresentativeClinton, MSPhysical and Environmental Demands: Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent, standing, occasional twisting, and frequent walking. Basic knowledge of medical terminology, Basic knowledge of revenue cycle functions, Ability to pay attention to detail, Ability to maintain a professional appearance and attitude, Ability to read, write, type, and follow oral and written directions, Ability to work independently to effectively and efficiently perform assigned duties, and good interpersonal communication and organizational skills, and proven ability to work effectively with others.
Patient Account Representative - Health Benefits Coordinators University of Mississippi Medical CenterPatient Account Representative - Health Benefits CoordinatorsJackson, MSPhysical and Environmental Demands: Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent, standing, occasional twisting, and frequent walking. Basic knowledge of medical terminology, Basic knowledge of revenue cycle functions, Ability to pay attention to detail, Ability to maintain a professional appearance and attitude, Ability to read, write, type, and follow oral and written directions, Ability to work independently to effectively and efficiently perform assigned duties, and good interpersonal communication and organizational skills, and proven ability to work effectively with others.
Patient Account Representative - Professional Govt FU University of Mississippi Medical CenterPatient Account Representative - Professional Govt FUClinton, MSPhysical and Environmental Demands: Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent, standing, occasional twisting, and frequent walking. Basic knowledge of medical terminology, Basic knowledge of revenue cycle functions, Ability to pay attention to detail, Ability to maintain a professional appearance and attitude, Ability to read, write, type, and follow oral and written directions, Ability to work independently to effectively and efficiently perform assigned duties, and good interpersonal communication and organizational skills, and proven ability to work effectively with others.
Specialist-Accounts Receivable Follow Up Baptist Memorial Health Care CorpSpecialist-Accounts Receivable Follow UpJackson, MSPerforms required actions to resolve the account balance promptly by submitting appeals, correcting account information, coordinating requests for medical records, requesting and/or performing posting of account adjustments, requesting an account rebill and any and all other actions necessary to secure account payment and/or bring the account to successful closure. Ability to type and key accurately, problem solving, written an d oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MS$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
Medical Director - ENT CVS Health CorpMedical Director - ENTMS$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Informatics Consultant CVS Health CorpInformatics ConsultantMS$43,888–$102,081 / year1+ year(s) computer skills and knowledge of Microsoft Word, Excel, PowerPoint and Adobe Acrobat Pro experience with reporting platforms such as: Big data analytics, data mining, and Tableau. Become a subject matter expert for Client Management, clients and brokers related to our internal analytics tool and their client's data.
Network Hospital Quality Coordinator Blue Cross & Blue Shield of MississippiNetwork Hospital Quality CoordinatorFlowood, MississippiKnowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases, Tenth Revision (ICD10), Uniform Billing (UB) Revenue and National Drug Code (NDC) coding. Strong interpersonal skills to build solid business relationships and collaborate with diverse teams including medical providers, frontline staff and those from other Blue Plans or Blue Cross Blue Shield Association.
Staff Software Development Engineer CVS Health CorpStaff Software Development EngineerMS$106,605–$284,280 / yearFurthermore, the Staff Engineer role includes closely working with a team of engineers to drive delivery excellence, partner with business and other IT leaders to build digital assets, provide expert level support to resolve complex issues and provide RCA, identify gaps in systems in current digital eco system and provide solutions to enhance overall performance. CVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers' lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world.
Staff Development Engineer - Fulfillment CVS Health CorpStaff Development Engineer - FulfillmentMS$106,605–$284,280 / year7+ years of software development in enterprise / web / cloud applications • 5+ years of backend software development experience with programming languages/tools including: Java, Spring Boot, Kafka • 3+ years of distributed caching experience • 3+ years of experience having a track record developing in AWS or GCP or Azure or similar public cloud environments (GCP preferred) • 3+ years of experience in design, development and operationalizing microservices based web/webservices application in cloud native environment • 3+ years of technical lead experience within a matrixed environment, including mentoring junior engineers and working cross collaboratively between architecture, product, etc. • Understand security threats and patterns and ensure adherence to all regulatory initiatives, HIPAA, PHI, PII, locational and contractual data restrictions • Experience with build automation technologies like Maven, Gradle, Jenkins, Harness • Expert knowledge with functional, imperative and object-oriented languages and methodologies • Experience with Cassandra and Postgres - preferred • Experience with test-driven development and automated testing frameworks • Experience with Scrum/Agile development methodologies.
Application Security Engineer Ryder System IncApplication Security EngineerJackson, MSCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
Data Conversion Lead MaximusData Conversion LeadJackson, MSFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Provider Clinical Quality Specialist Blue Cross & Blue Shield of MississippiProvider Clinical Quality SpecialistFlowood, MississippiAs the driving force of this initiative, this Clinician partners with network providers and hospitals, as well as internal stakeholders to evaluate, structure, implement, and enhance the components of a best practice model value-based program to establish guidelines which support optimal patient care experiences and health outcomes. Maintains knowledge of relevant provider quality initiatives and value-based reimbursement models such as Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Bundled Payment for Care Improvement (BPCI) and Physician Quality Reporting System (PQRS).