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Position located in Phoenix, AZ
Claims Recoup & Collection Analyst at TriWest Healthcare Alliance
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Claims Recoup & Collection Analyst?
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The Business Analyst is customer focused and facilitates turning data into information to drive business processes and monitoring. The position collaborates to ensure relevant analysis and complete, timely reporting is provided to meet TriWest business needs and Veteran’s Administration’s Healthcare requirements. Facilitates meetings, identifies, collects, organizes and prioritizes data requirements and business processes changes to meet reporting requirements. Clarifies complex business issues and recommends solutions. Advocates business process improvement through data analysis, process change and technology application.
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The IT Business Office Analyst, reporting to the Manager, IT Business & Resource, is responsible for work as a key part of the IT business operations, to include vendors, contracts, IT budget, IT staffing management, and asset management. This role is also responsible for IT operational metrics, supporting within budget and quality delivery of all IT projects/programs, and change & risk management controls. The business office analyst will also play a key role in building, tracking, and maintaining the IT department overall training and development.
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Job Summary
Ensures accurate, timely maintenance and synchronization of critical provider data across all provider databases, and systems. Accesses and utilizes multiple software applications. Applies business rules and knowledge of Provider contract language, pricing and reimbursement methodologies to each database/system to validate Provider information across systems.
Communicates with internal and external clients by phone and email to clarify data and follow-up on issues, while working under timeline, accuracy and production targets.
Requires the ability to manage a large amount of complex information and must be able to communicate clearly and draw sound conclusions. Supports the maintenance of accurate, up-to-date provider data to include updates, changes, additions and terminations for assigned files.
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Job Summary
Develops and maintains provider relationships within states TriWest is responsible for direct contracting. Manages network development and supervises network contracting staff in region. Develops hospital, physician and ancillary service agreements, ensures adherence with government operational manuals, monitors network shortfalls, and resolves access issues throughout the assigned region. Facilitates resolution of escalated provider issues, and promotes TriWest Corporate initiatives.
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Utilizes balanced knowledge and approach against technical, people, and process tracks. Provides guidance of high performing technical team, which supports extremely complex, highly secured environment. Team provides server and application support functions in highly virtual environment. Manages team with expert knowledge of Windows systems design based on Microsoft best practices. Participates in and coordinates efforts for the design, architecture, implementation, and maintenance of highly available / highly secure computing environment.
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This Position in Located in Phoenix, AZ
Project manager at TriWest Healthcare Alliance
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Project Manager?
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Provides non-clinical support for the Medical Management and Operations Departments. Performs the printing, prepping and distribution of outgoing and incoming mail. Processes outgoing mail according to postal regulations. Re-processes returned mail. Makes routing decisions regarding incoming correspondence based on defined processes. Collects and enters data into the TriWest medical management systems. Parses and triages incoming faxes to the appropriate task lists. Makes outbound calls to facilities or providers. Operates and maintains mail processing machinery. Operates and scans multiple incoming documentation.
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Leads a project team dealing with a specific module or functional area. Understands the business strategy of client department and defines the information systems requirements to meet the business requirements. Collaborates with other department resources to ensure system integration. Monitors, defines, and reports on critical path workflows. Resolves issues or escalates issues as required. Drives the design and implementation of new business processes within required configuration.Functions as lead in the design, coding, debugging, testing, documentation, and supporting of in-house applications and customization of vendor-supplied applications. Provides expert functional and technical support for vendor applications and programs. Collaborates with the Data Base Administrator on system upgrades. Develops and supports multiple-system interfaces and integration.
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This Position in Located in Phoenix, AZ
Claims Reviewer at TriWest Healthcare Alliance
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Claims Reviewer?
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Job Summary
Supports the administration of the contract management system to ensure proper functionality, accuracy of documents, and resolve issues that arise. Supports in the administering the e-signature program to ensure full utilization of the program as well as troubleshoot issues related to this system. Perform training for staff on the functionality of both programs.
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Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Director, Clinical Quality Data Analyst?
In this role, the Director is responsible for the analysis of clinical quality data sets to identify clinical quality trends and issues, and direct strategies to improve beneficiaries' clinical markers. This position is responsible for coordination with Data Management and vendors to ensure accuracy of medical management reports and with Provider Services to build scorecards.
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Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Manager, Benefits & Wellness?
Do you find satisfaction in leading the overall direction and administration of company benefits, leave of absence and workers' compensation and related benefit programs? Our Manager, Benefits & Wellness will develop and recommend new and/or improved programs and plans while ensuring compliance with all federal, state and local regulations and laws. Do you thrive on challenge and take your responsibilities seriously? Are you looking for a job that is meaningful and rewarding?
If you enjoy problem solving, building relationships, and delivering customer service in a collaborative environment, we have a position for you
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Associate General Counsel at TriWest Healthcare Alliance
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Associate General Counsel?
Do you find satisfaction in providing advice and counsel to TriWest business teams to help move forward engagement with vendors and subcontractors, and to help manage and develop contractual frameworks for privacy and information security? Are you well-versed in contract drafting and negotiation, and able to advise and guide our business teams on the best strategy for each situation? If you are you looking for a job that is meaningful and rewarding, we have a position for you.
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Are you a driven and independent individual? Do you have healthcare and/or project management experience? Do you expect great results out of yourself and others? If so, we might be a fit. TriWest Healthcare Alliance has been on a Mission to serve our nation’s Veterans and their families since 1996. We are an evolving team of professionals that will do “Whatever it Takes” to serve our nation’s heroes in partnership with the VA. We are looking for talented individuals with a unique blend of skills to advance our organization through project management.
Responsible for leading and managing large, complex, cross-functional project initiatives for an industry-leader supporting healthcare needs of the nation’s Veterans and military members. Works within a dynamic, fast paced Enterprise Project Management Office (ePMO); understands and values project management; encourages professional development and empowers its staff to achieve their best. The Sr. PM applies recognized project management concepts, professional discipline, ethics and conduct standards to deliver a wide range of integrated enterprise applications, services and results. Leads, manages, develops and implements various-sized, cross-functional, enterprise wide projects. Responsible for monitoring and reporting on individual business and IT projects and initiatives. Produces detailed and comprehensive plans, reports, analyses and recommendations. The work is accomplished through a matrix of project and functional managers and departments focused on managing changes in business operations, products or services delivery and implementing improved changes.
Establishes, maintains and carries out active and effective risk and change communications among stakeholders. Serves as a project management role model, trainer, coach, mentor for the organization. Success is measured in terms of completing the project within the defined constraints and compliance with methodologies and best practice. This position reports to the Director, ePMO.
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Are you a driven and independent individual? Do you have healthcare and/or project management experience? Do you expect great results out of yourself and others? If so, we might be a fit. TriWest Healthcare Alliance has been on a Mission to serve our nation’s Veterans and their families since 1996. We are an evolving team of professionals that will do “Whatever it Takes” to serve our nation’s heroes in partnership with the VA. We are looking for talented individuals with a unique blend of skills to advance our organization through project management.
The Senior Program Manager is responsible for ensuring that enterprise wide programs are well defined, planned, tracked and communicated in a consistent manner; responsible for building partnering relationships within stakeholders; responsible for on time, within budget and quality implementation of enterprise wide programs; responsible for executing project management best practices.
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Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Medical Review Clerk?
Reviews medical documentation to determine correct coding on submitted medical and behavioral health claims utilizing appropriate clinical staff resources as needed to assist in review. Update authorizations as necessary with appropriate codes.
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Position Located in Phoenix, AZ
Quality Analyst at TriWest Healthcare Alliance
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Quality Analyst?
-
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Medical Management Assistant?
Reviews and enters complex authorizations and referrals from VA and providers. Ability to effectively communicate medical information, test results, diagnoses and or proposed treatment in a manner easily understood by the patient. Must be able to effectively communicate with clinical staff. Ensures accurate data entry and completion of authorization data from customer information, medical records, referral/authorization forms, assists Patient Service Representatives (PSRs) in obtaining consult reports within required turnaround times. Provides initial data entry related to potential quality issues. Under the direction of a supervisor, requests appropriate records and process initial review of those records. Works in a fast-paced production environment.
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Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Are you our next Clinical Reviewer - LPN?
Applies clinical knowledge to make determinations for pre-authorizations of specific procedures and services to ensure adherence to contract benefits. Conducts Medical / Surgical medical necessity reviews. Compiles information needed to process prior authorization requests and documents in the medical management information system. Prepares and presents more complex cases for Medical Director review. Refer cases to Case Management and Disease Management as appropriate. Advises non-clinical staff on clinical and coding questions. Conducts pre-admission screening and assessments.