TriWest Healthcare Alliance

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Recruiting Location Phoenix, AZ
ID 2020-3277
Provider Data Specialist at TriWest Healthcare Alliance - Phoenix    THIS POSITION IS POSTED EXTERNALLY BUT IS ONLY FOR QUALIFIED TRIWEST INTERNAL EMPLOYEES.   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.     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.
Recruiting Location Phoenix, AZ
ID 2020-3275
Claims Clerk at TriWest Healthcare Alliance - Phoenix and El Paso   THIS POSITION IS POSTED EXTERNALLY BUT IS ONLY FOR QUALIFIED TRIWEST INTERNAL EMPLOYEES.   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.   Provides clerical support for the Claims department, including receipt and processing of daily incoming mail. Performs photocopying , pulling claims and Explanations of Benefits (EOBs) off the on-line system using Filenet and Emdeon software. Annotates items in claims software systems. Maintains control of incoming faxes, including appropriate logging of receipt. Maintains files for Administrative Checks.  
Recruiting Location Anchorage, AK
ID 2020-3273
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, Operations?    This position manages daily operations and staff with a focus on delivering timely, accurate and exemplary customer service. The Manager will oversee staff handling phone and chat inquiries regarding all aspects of TriWest’s managed care programs, including information and assistance with program eligibility, authorizations for care, and claims. The Manager will lead and support, in collaboration with other TriWest departments, to promote a positive culture of service, increasing operational effectiveness, and accountability. In leading assigned staff, the Manager will also guide their activities associated with training, quality assurance, reporting and monitoring of performance metrics, policies and procedures, on-line systems, and cross-functional departmental communication with the goal of achieving contract standards, annual goals and objectives.
Recruiting Location Phoenix, AZ
ID 2020-3272
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 Sr. HRIS Analyst?     Provides Human Resources Information System (HRIS) support to Human Resources staff.  Coordinates the development and maintenance of the HRIS database, HRIS-related analytics, and systems-related processes.  Monitors system processing and tracks department administrative activity to ensure data integrity.  Oversees daily HRIS operations for internal control purposes.  Coordinates the mechanics of system processing, tracking of confidential information, and related PeopleSoft forms.  Develops and maintains query reports for user groups.  Collaborates with IT staff on system issues and problem resolution.  Coordinates system enhancements and modifications on the end user side.  Assists with PeopleSoft implementation issues and works with other HRIS staff on daily operational issues.  Functions as a department resource on PeopleSoft system training.
Recruiting Location Anchorage, AK
ID 2020-3271
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 Customer Service Representative?    Provides outstanding customer service related to Veteran care through the Community Care Network (CCN) in a fast-paced contact center. Responds to inbound calls and chat messages regarding authorizations for medical and behavioral health care, provider status and availability, or claims payment and status. Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. May make outbound calls to schedule appointments based on Veteran or VA request. Resolves administrative eligibility discrepancies through account research and review.
Recruiting Location Anchorage, AK
ID 2020-3269
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 Quality – RN?    Ensures compliance with contract requirements for clinical quality management (CQM) to ensure quality care for Veterans. Identifies and evaluates potential quality issues and prepares summaries for further review and analysis. Supports activities of peer review and quality and safety committees. Reviews discharge summaries and consultation reports for compliance with clinical quality and contract requirements.
Recruiting Location Anchorage, AK
ID 2020-3268
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 Resolution Representative?    Ensures accurate, timely maintenance, and synchronization of critical provider and or authorization data within provider/authorization databases and Facets.  Researches and resolves Veterans’ claims customer service inquiries. Accesses and utilizes multiple software applications, applies business rules and knowledge of provider and or authorization processes.  Communicates with internal and external customers by phone and email to clarify data and follow up on issues. Works under timelines while meeting accuracy and production targets.
Recruiting Location Anchorage, AK
ID 2020-3267
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 Customer Service Representative?    Handles inbound phone calls from Veterans, VA and other customers. Performs claims research and resolution regarding both institutional and professional claims.  Reviews claims and responds to Veteran questions regarding billing issues. Works in a detailed, fast-paced, and repetitive production environment. Interacts with customers in a professional, formal manner where the focus is on completing the task pleasantly and with high quality and accuracy.
Recruiting Location Anchorage, AK
ID 2020-3266
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 Care Authorization Specialist?    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.
Recruiting Location Phoenix, AZ
ID 2020-3265
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 Director?    Oversees and participates in clinical quality reviews, peer review, and provider interactions. Works closely with and oversees clinical staff reviewing potential quality issues and appropriateness of care. Develops provider and system-based corrective action plans as needed. Chairs and coordinates quality and other committee meetings as assigned. Documents reviews of clinical quality and appropriateness of care in the medical management system. Collaborates with VA, network providers, and TriWest staff to assure timely, appropriate and high quality care. Uses data to facilitate and optimize the delivery of health care services. Interacts directly with beneficiaries, as indicated, to assure a high level of satisfaction.
Recruiting Location Phoenix, AZ
ID 2020-3263
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 Business Analyst?    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.
Recruiting Location Phoenix, AZ
ID 2020-3262
Performance Reporting 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.     Provides and develops processes for reports, analysis and metrics to support recommendations regarding Call Center performance, IVR performance, data integrity and other production and time tracking systems. Creates and maintains the department database. Plays a key role in the development and maintenance of the contact center production and performance scorecard. Provides reporting support and supports internal customers with special information needs.
Recruiting Location Phoenix, AZ
ID 2020-3261
Workforce 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.     This position is responsible for providing direct Workforce Management support. It focuses on staffing levels and applies workforce management techniques and concepts to improve productivity outcomes. Techniques include real time adherence (RTA), routine performance snapshots, communications, attendance tracking and processing customer requests. The role may also be responsible for ongoing maintenance of the NICE IEX software and eResource planner software applications.  
Recruiting Location Anchorage, AK
ID 2020-3260
Job Summary   Works under the direction of the Director, Network Development and in close coordination with the Vice President, Alaska Operations to develop and maintain relationships and serve as a TriWest liaison with the Alaska Native Health Consortium (ANHC), individual Tribal Health Programs (THPs), and the Indian Health System (IHS) in Alaska. Works closely with the provider network development team to manage and maintain network development activities with ANHC, and other THPs as well as HIS entities outside of Alaska through establishing relationships and executing agreements needed to serve the Alaska Veteran population with a focus on Alaska Native Veterans to be supported and served by TriWest through the VA Community Care Network (CCN) in Alaska. Facilitates resolution of escalated provider issues, and promotes TriWest Corporate initiatives
Recruiting Location Phoenix, AZ
ID 2020-3259
Sr. IS Security Remediation Engineer 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.     Responsible to actively promote, maintain and validate the availability, integrity, and confidentiality of the organization information assets in compliance with company security policies, standards and best practices. Responsible for identifying and implementing the appropriate security tool sets to assess the company's computing infrastructure and applications in the environment. Responsible for identifying and implementing the appropriate security tool sets to assess the company's computing infrastructure and applications in the environment. Responsible for implementation and administration of the process that tracks the active status and access level for security remediation, latest compliance, organizational patching, configurations change management, system hardening requirements and penetration testing.Provide technical security leadership and oversee the implementation and administration, in collaboration with other Information Technology (IT) teams, of security tool sets including network and host based remediation and analysis scanning tools and controls to meet the company requirements and needs. Conduct enterprise wide vulnerability assessment scheduling, communications, report generation and problem resolution. Consult with IT personnel on findings to identify technical, procedural or people related vulnerabilities system and application remediation. Assist auditors with their vulnerability scanning requirements and validate internal security documentation is relevant and up to date.  
Recruiting Location Phoenix, AZ
ID 2020-3257
IT Project Manager, Sr. 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.   Coordinates multiple IT-related projects. Develops and executes system or solution-level program plans and specifications to support of the implementation and release of new products, services, or processes. Manages clearly-defined and focused programs. Directs and organizes cross-functional teams to ensure all deliverables are met. Coordinates multiple projects across multiple disciplines (technology, business, project management) and manages the full lifecycle of assigned programs to achieve deadlines and desired functionality.. Collaborates with other Project Managers (both IT and other departments), vendors and other partners who have accountabilities for project execution. Monitors cost, schedule, and technical performance of component projects and operations, while working to ensure the ultimate success of the project/projects. Determines and coordinates the sharing of resources among their assigned projects to optimize outcomes. Interface with stakeholders, including external stakeholders. Functions as an advocate to support higher-level management priorities. Provides leadership, direction, and guidance to their teams and direct reports.
Recruiting Location Anchorage, AK
ID 2020-3255
This position is an onsite position located in Anchorage, Alaska   Job Summary   Directs multiple large TriWest projects, working closely with program managers, project managers and business leaders to understand and report quality and performance issues and address systemic concerns. Diagnoses and implements solutions. Conducts quantitative and qualitative analysis and assessment of TriWest programs, processes, and outcomes. Utilizes quantitative tools and techniques to perform data-based analysis. Utilizes consulting and facilitation approaches for qualitative assessments. Produces complete and informative, reports, describes options in terms of cost/benefit, and makes recommendations to leadership and/or user groups for process/program improvement and/or decision-making. 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. Works quickly and thoroughly to perform analyses, report results, produce deliverables and support implementation on time.
Recruiting Location Phoenix, AZ
ID 2020-3247
Important Notice to All Candidates - Please Read   IMPORTANT! We’ve been made aware of a possible recruiting scam. Please read this important message to protect your personal information while applying for a career at TriWest.   Should you be contacted about an employment opportunity at TriWest, please be aware that TriWest recruiters will never communicate with any employment candidate or any other member of the public through a "@gmail" email address or conduct business in a Google Hangout.   Thank you for your interest in joining our team. TriWest Healthcare Alliance Recruitment
Recruiting Location Phoenix, AZ
ID 2020-3245
Important Notice to All Candidates - Please Read   IMPORTANT! We’ve been made aware of a possible recruiting scam. Please read this important message to protect your personal information while applying for a career at TriWest.   Should you be contacted about an employment opportunity at TriWest, please be aware that TriWest recruiters will never communicate with any employment candidate or any other member of the public through a "@gmail" email address or conduct business in a Google Hangout.   Thank you for your interest in joining our team. TriWest Healthcare Alliance Recruitment
Recruiting Location Phoenix, AZ
ID 2020-3244
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, Provider Data & Management?