Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Cheyenne, WYRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines 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, Military members and family (as warranted), 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. The PI Investigator t 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), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Healthcare Counsel TriWest Healthcare AllianceHealthcare CounselCheyenne, WYRemoteFull timeTriWest will prioritize candidates with experience with healthcare regulatory matters, including Medicare and Medicaid and conditions of participation in federal healthcare programs, anti-kickback laws, self-referral laws, HIPAA, and transactional matters for health care providers. Supports the Office of General Counsel in advising and producing attorney work products that support TriWest's healthcare-related departments including, but not limited to, Provider Services, Medical Management, Program Integrity, and Claims.
Healthcare Licensing and Surveys Administrator 2026-01078 State of WyomingHealthcare Licensing and Surveys Administrator 2026-01078Cheyenne, WY$9,754.66–$10,838.51 / yearAA) VETERANS PREFERENCE: If you are a war veteran as defined in section 101, Title 38, United States Code or are the surviving spouse of a war veteran who receives survivor benefits from the federal government based on the veterans military service, and wish to claim veterans preference, please attach the appropriate documentation substantiating your claim. The at-will position acts as the State healthcare licensure authority and oversees Medicare and Medicaid certification and compliance with Conditions of Participation on behalf of the federal Centers for Medicare and Medicaid Services (CMS).
Project Manager Sr TriWest Healthcare AllianceProject Manager SrCheyenne, WYRemoteFull timeTechnical Skills: Knowledge of the Managed Care concepts, proficient with statistical analysis, data management and analysis, project management techniques, benchmarking practices and techniques, quality improvement tools and techniques, presentations skills, and proficient with Excel, SQL, Word, PowerPoint, and Visio. Supports project implementation when required using project management tools to develop project plans/timelines, coordinate/manage project, monitor and report status, progress and areas of risk in relation to established project objectives, requirements and timelines.
Solutions Program Manager TriWest Healthcare AllianceSolutions Program ManagerCheyenne, WYRemoteFull timeThe Solutions Program Manager is responsible for ensuring that our strategic, enterprise wide programs are well defined, planned, tracked and communicated in a consistent manner, responsible for building partnering relationships with C-Suite executives and other stakeholders; responsible for on time, within budget and quality implementation of enterprise wide programs; responsible for executing project management best practices. • As part of the Program Manager's Team, develop effective collaborative relationships with TriWest's C-Suite executive and other leaders in Operations, Health Care Services, Provider Network and IT to ensure that TriWest meets contractual requirements and fulfills organizational objectives.
Provider Program Manager - APM TriWest Healthcare AllianceProvider Program Manager - APMCheyenne, WYRemoteFull timeDevelops effective collaborative relationships with TriWest's inter and intra-departmental stakeholders and other SMEs, C-Suite executives, and other leaders in Operations, Health Care Services, Provider Network, and IT to ensure that TriWest meets contractual requirements and fulfills organizational objectives. The Provider Program Manager ensures that strategic, enterprise-wide programs are well defined, planned, tracked, and communicated in a consistent manner; is responsible for collaborating with C-Suite executives and other stakeholders; and is responsible for deliverables that meet defined requirements and for utilizing project management best practices.
Performance Improvement Mgr TriWest Healthcare AlliancePerformance Improvement MgrCheyenne, WYRemoteFull timeThis individual contributor role leads enterprise-wide Quality Improvement Projects (QIPs) focused on operational excellence, Corrective Action Request (CAR) responses, and measurable stakeholder outcomes. Multi-Tasking / Time Management: Prioritize and manage multiple concurrent initiatives to meet changing deadlines and requirements within a high-volume environment, including project timelines, deliverables, and key performance indicators.
Direct Contracting Manager TriWest Healthcare AllianceDirect Contracting ManagerCheyenne, WYRemoteFull timeMedicaid, Medicare, TRICARE, VAPC3), and the insurance industry; skill in diplomacy and negotiation; skill in financial analysis to analyze contractual reimbursement; skill in project management; skill in presentation; proficient with Excel. Develops hospital, physician and ancillary service agreements, ensures adherence with government operational manuals, monitors network shortfalls, and resolves access issues throughout the assigned region.
Alternative Health & Advocacy Solutions COE Senior Project Manager CVS Health CorpAlternative Health & Advocacy Solutions COE Senior Project ManagerWYRemote$67,900–$199,144 / yearActing as the central liaison between external partners and internal stakeholders, the Senior Project & Program Manager collaborates closely with Sales, Client Management, Product, Operations, Implementation, and Executive Leadership teams to ensure partner solutions are effectively positioned, implemented, and supported throughout the client lifecycle. Success in this role requires strong relationship management, project and program leadership, operational excellence, strategic thinking, and the ability to influence cross-functional teams to deliver business outcomes that enhance client experience, retention, growth, and innovation.
Rural and Frontier Health Unit Manager 2026-01751 State of WyomingRural and Frontier Health Unit Manager 2026-01751Cheyenne, WY$7,805.20–$8,671.86The programs and grants within this unit include the Office of Rural Health, the Wyoming Cares/Wyoming Shares organ donation program, the Primary Care Office, the Medicare Rural Hospital Flexibility Program, the Small Rural Hospital Improvement Grant Program, and the Community Services Program. (AA) VETERANS PREFERENCE: If you are a war veteran as defined in section 101, Title 38, United States Code or are the surviving spouse of a war veteran who receives survivor benefits from the federal government based on the veterans military service, and wish to claim veterans preference, please attach the appropriate documentation substantiating your claim.
Manager, Business Analytics CVS Health CorpManager, Business AnalyticsWY$66,330–$145,860 / yearThis involves extracting, analyzing, and interpreting contracting, utilization, financial, and clinical/quality data from various sources to support nationwide payer contract negotiations, market penetration, conversion, and expansion strategies, value-based care initiatives, and other quantitative analysis & reporting requirements. To develop and deliver decision support tools & insights via creating and sustaining analytics & reporting assets and leveraging business intelligence resources in support of contracting, financial and operational strategic decision-making by Retail Health leadership.
Field Reimbursement Manager - True North Inspire Medical Systems Inc.Field Reimbursement Manager - True NorthCheyenne, WYRemote$160,000–$190,000 / yearYou will be working independently in a fast paced, highly visible environment as well as collaboratively with the internal program prior authorization support services and field sales to ensure all customer needs are met supporting patient therapy access and communicating coverage challenges across specific payer channels with guidance on how to navigate and minimize those potential hurdles. Both proactively and reactively navigate and address individual account and patient access issues that occur by partnering with external and internal stakeholders including internal reimbursement team and field sales colleagues.
RN / Regional Manager (CO, WY) CorrHealthRN / Regional Manager (CO, WY)Cheyenne, WYFull timeProvides guidance, direction, and support to the HSAs, ensuring our clinical staff are trained and supporting in the delivery of care, providing key performance information to our clients, acting as the conduit for the sharing of information between the field and the corporate office. Ensures the highest quality clinical care is delivered to the inmates entrusted to our care by allocating our healthcare funds to deliver the most appropriate care to the greatest number of inmates.
NewManager, Data Engineering (Master Data Management) MDM TriWest Healthcare AllianceManager, Data Engineering (Master Data Management) MDMCheyenne, WYRemoteFull timeTechnical Skills: In-depth knowledge of all application functionality, security, development, and system administration; knowledge of relevant technology, tools and middleware; proficient change agent; knowledge of the agile methodology and software maintenance and support. • Develops and maintains ongoing relationships with hardware, software, consultant, and employee resource vendors to insure that TriWest systems are adequately supported and external opportunities are understood and considered in the planning process.
Manager, Data Operations TriWest Healthcare AllianceManager, Data OperationsCheyenne, WYRemoteFull timeTechnical Skills: In-depth knowledge of all application functionality, security, development, and system administration; knowledge of relevant technology, tools and middleware; proficient change agent; knowledge of the agile methodology and software maintenance and support. The manager serves as a bridge between data engineering, analytics, and business stakeholders to ensure timely, high-quality data delivery for operational and strategic needs.
Executive Recruiter TriWest Healthcare AllianceExecutive RecruiterCheyenne, WYFull timeServing as a trusted advisor to executive hiring leadership, the Executive Recruiter develops and executes proactive, research-driven search strategies to identify, attract, and secure top-tier leadership talent. The Executive Recruiter leads full lifecycle recruitment for executive level Director, Vice President, Chief-level, and other highly specialized leadership roles across TriWest Healthcare Alliance.
Sup, Clinical Quality Mgmt TriWest Healthcare AllianceSup, Clinical Quality MgmtCheyenne, WYRemoteFull timeThe Supervisor oversees clinical and non-clinical staff supporting CQM programs by overseeing and providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.
NewMedical Support Assistant (MSA), Remote - Cheyenne, WY CLFC Healthcare and CommunicationsMedical Support Assistant (MSA), Remote - Cheyenne, WYCheyenne, WYRemoteCLF Consultants LLC (DBA: CLFC Healthcare and Communications) is a nationwide healthcare staffing and language access services organization supporting federal, state, and local government agencies. Compensation: Hourly base set to the Service Contract Act prevailing wage for your location (see the pay range on this posting), plus a $5.55 per hour Health and Welfare benefit and a quarterly performance bonus up to $2,080 per year.