Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Fargo, NDRemoteFull 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).
NewHealthcare Revenue Cycle Consultant - Remote Eligible Eide Bailly LLPHealthcare Revenue Cycle Consultant - Remote EligibleFargo, North DakotaRemote$100,000–$150,000 / yearFull timeA typical day as a Healthcare Revenue Cycle Consultant might include: Conducting onsite and remote revenue cycle assessments for healthcare providers (primarily hospitals), including evaluating patient access, mid-cycle, and back-end functions; identifying improvement opportunities and recommending solutions. You have well-rounded knowledge of CMS, and other state and federal regulatory guidance related to the healthcare industry with a strong understanding of inpatient, outpatient and professional billing and payer requirements.
Healthcare Counsel TriWest Healthcare AllianceHealthcare CounselFargo, NDRemoteFull 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.
NewHealthcare Market Finance Lead Humana IncHealthcare Market Finance LeadND$104,000–$143,000 / yearTo ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Market Finance Lead will also partner with actuarial, corporate finance, clinical, risk adjustment, market operations, provider engagement, hospitals, ancillary partners, sales/MarketPoint and value-based care providers.
NewStaff Pharmacist - Family HealthCare Pharmacy South North Dakota University SystemStaff Pharmacist - Family HealthCare Pharmacy SouthFargo, ND$105,000–$140,000 / yearProvide clinical pharmacy services, including but not limited to medication reconciliation, medication synchronization, medication therapy management, disease state management, formulary review, preventive care initiatives, collaborative practice activities, and medication information services. Assist patients in accessing affordable medications through Family HealthCare programs, manufacturer assistance programs, coupons, and community resources.
Director, Healthcare Market (HD), Rare Disease - Midwest Genentech IncDirector, Healthcare Market (HD), Rare Disease - MidwestFargo, ND$209,900–$389,900 / yearThe Rare Disease Healthcare Director (RD HD) is responsible for leading a cross functional team whose responsibilities will be focused on supporting patients, caregivers, HCP and advocacy needs holistically within the Neurological Rare Disease (NRD) and Rare Blood Disorder (RBD) communities. The RD HD is tasked with ensuring both clinical and access questions are compliantly addressed for the patient, caregivers and HCP accounts including other geographically aligned stakeholders i.e. social workers, genetic counselors, health systems etc. in order to provide safe and effective patient care.
NewHealthcare Loan Closer US BankHealthcare Loan CloserFargo, ND$33.92–$41.46 / hourWorking closely with Healthcare Relationship Managers and Practice Finance Business Development Officers, you'll help ensure a seamless client experience while coordinating complex loan closings, managing documentation, and maintaining compliance with bank and regulatory requirements. Lead pre-closing and closing activities for healthcare and practice finance loans, including commercial real estate, construction, term loans, lines of credit, and investment real estate transactions.
NewPart-Time Healthcare Environmental Technician - Fargo ND Arcwood Environmental, LLCPart-Time Healthcare Environmental Technician - Fargo NDFargo, North DakotaPart timeProvides inspection services to clients, including collection bin inspections, data collection via mobile app, packaging of full containers for shipment and conducting other various facility inspections as required. With deep expertise and innovative waste management technology across a growing nationwide footprint, Arcwood protects people, communities, and the environment through work that often happens behind the scenes.
NewPart Time Healthcare Environmental Technician Fargo ND Heritage Environmental Services, LLCPart Time Healthcare Environmental Technician Fargo NDFargo, NDProvides inspection services to clients, including collection bin inspections, data collection via mobile app, packaging of full containers for shipment and conducting other various facility inspections as required. With deep expertise and innovative waste management technology across a growing nationwide footprint, Arcwood protects people, communities, and the environment through work that often happens behind the scenes.
Part Time Healthcare Device Technician Fargo ND Heritage Environmental Services, LLCPart Time Healthcare Device Technician Fargo NDFargo, NDProvides inspection services to clients, including collection bin inspections, data collection via mobile app, packaging of full containers for shipment and conducting other various facility inspections as required. With a focus on Private Capital and Real Assets, EQT owns and supports leading companies across Europe, Asia-Pacific, and the Americas, fostering sustainable growth, operational excellence, and market leadership.
Healthcare Cost Reporting/Reimbursement Manager - Remote Eligible Eide Bailly LLPHealthcare Cost Reporting/Reimbursement Manager - Remote EligibleFargo, NDRemote$95,000–$135,000 / yearLocation: Any state with an Eide Bailly office Work Arrangement: In-office, hybrid, or remote with the ability to come into an Eide Bailly office as needed Typical Day in the Life In this role, you will lead healthcare financial projects, including Medicare and Medicaid cost report services for a variety of healthcare facilities, while also supporting other reimbursement initiatives as needed. A typical day as a Healthcare Reimbursement Manager might include the following: Overseeing cost report preparation and reimbursement engagements to ensure objectives are met, including supporting staff development, addressing client needs, and maintaining engagement profitability.
NewHealthcare Loan Closer U.S. BancorpHealthcare Loan CloserFargo, ND$33.92–$41.46 / hourWorking closely with Healthcare Relationship Managers and Practice Finance Business Development Officers, you'll help ensure a seamless client experience while coordinating complex loan closings, managing documentation, and maintaining compliance with bank and regulatory requirements. Lead pre-closing and closing activities for healthcare and practice finance loans, including commercial real estate, construction, term loans, lines of credit, and investment real estate transactions.
Healthcare Reimbursement Associate Eide Bailly LLPHealthcare Reimbursement AssociateFargo, ND$64,000–$87,000 / yearA typical day as a Healthcare Reimbursement Associate might include the following: Using specialized software to prepare Medicare and/or Medicaid cost reports for a variety of healthcare clients ranging from hospitals to nursing facilities. Reviewing trial balances, financial statements, and client data ensuring accuracy and completeness of cost report.
NewManager, Data Engineering (Master Data Management) MDM TriWest Healthcare AllianceManager, Data Engineering (Master Data Management) MDMFargo, NDRemoteFull 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.
Supervisor, Provider Network Management TriWest Healthcare AllianceSupervisor, Provider Network ManagementFargo, NDRemoteFull timeTechnical Skills: Working knowledge of provider contract support functions and provider data systems; proficient with Word, Excel, and Provider Services data systems, with the ability to produce reports through querying; working knowledge of VA policies and procedures outlined in the VA Operations Manual, VA Policy Manual, DoD Regulations, and applicable TRICARE contract requirements. • Bachelor's Degree and 2 years of varied and responsible experience with health care programs, or any combination of education and experience that provides an equivalent background, plus the following: • If supporting TRICARE contract, must be a U.S. Citizen.
Project Manager Sr TriWest Healthcare AllianceProject Manager SrFargo, NDRemoteFull 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.
Performance Improvement Mgr TriWest Healthcare AlliancePerformance Improvement MgrFargo, NDRemoteFull 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.
NewSolutions Program Manager TriWest Healthcare AllianceSolutions Program ManagerFargo, NDRemoteFull 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.
Pharmacy Operations Manager Walgreen CoPharmacy Operations ManagerMoorhead, MN$22.50–$31 / hourAssists Pharmacy Manager in monitoring that all pharmacy and team member licensures, registrations and certifications are active and in good standing/ compliant with all regulatory and legal requirements. Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience.
Provider Program Manager - APM TriWest Healthcare AllianceProvider Program Manager - APMFargo, NDRemoteFull 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.