TriWest Healthcare Alliance

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Recruiting Location Phoenix, AZ
ID 2020-3172
Job Summary   This position is responsible for providing leadership in the development, implementation and oversight of all Provider Data and Credentialing functions in alignment with organizational strategic initiatives while ensuring a collaborative, open and inclusive work environment that is focused on quality outcomes and superior customer service. Accurate provider data and credentialing is central to pay or organizations so this position must drive for timely data processing with highest degree of accuracy possible. This position serves as the primary advisor to the organization and subject matter expert on matters related to assigned area of responsibility. Also directs, plans, develops, and implements performance standards, quality improvement, and delivery of service to create a positive impression of TriWest with its providers. This position is responsible for serving as a role model throughout the organization and representing TriWest in a positive manner both within and outside the organization.        
Recruiting Location Phoenix, AZ
ID 2020-3170
Manager, Systems Engineering 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.   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.
Recruiting Location Phoenix, AZ
ID 2020-3166
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 Program Integrity Support Specialist?     This position is under general guidance of the Director, Corporate Compliance and reports directly to the Supervisor, PI Specialist. The PI Support Specialist is responsible for providing claim processing and administrative support for Program Integrity (PI) investigations, law enforcement requests for information, other internal/external Fraud, Waste and Abuse (FWA) case development activities. The PI Support Specialist utilizes healthcare billing, claim processing, and medical record knowledge, in addition to research skills, to review and process of medical/surgical and behavioral health claims according to protocol directions established by PI Specialist. The PI Support Specialist captures savings and recoupment calculations, and reports on PI provider flag efficiencies. The PI Support Specialist compiles claim data, provider contracts, bank accounts, patient files (including, but not limited to medical records and claim images) and other information necessary to respond to law enforcement subpoenas related to FWA investigations.  The PI Support Specialist accurately records case referrals, claim activity, and law enforcement information requests, and assists the PI Supervisor with departmental reporting requirements. Ensures strict compliance with court appearance deadlines and HIPAA Privacy Rules.
Recruiting Location Phoenix, AZ
ID 2020-3165
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 Program Integrity Specialist?     This position is under the general guidance of the Director, Corporate Compliance and reports directly to the Supervisor, PI Specialist.  The PI Specialist 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) and the Healthcare Finance Administration (HCFA); requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).  Complies with the Veterans Affairs Patient-Centered Community Care (PC3) and Veterans Choice Program (VCP) contracts 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, 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.
Recruiting Location Phoenix, AZ
ID 2020-3164
System Engineer 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   Provides advanced support and oversight for infrastructure related hardware and software including but not limited to virtual and physical servers, active directory, sharepoint, exchange, and 3rd party applications. Functions as a technical expert for the implementation and operational support of noted technologies. Periodically will conduct preliminary analysis, evaluation and recommendation of future technologies and solutions.Functions as a collaborative troubleshooter for groups assigned to troubleshoot complex and critical issues.  
Recruiting Location Phoenix, AZ
ID 2020-3163
Do you bring creativity and innovative, ‘out-of-the-box’ ideas to your work?  Do you have healthcare and/or quality experience?   How about Lean or OpEx?  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 looking for a dynamic change agent to help us reinvent and reinvigorate our processes while establishing and driving and a best-in-class quality culture.   Reporting to the Director of Quality and Process Improvement, spearheads the development of quality improvement programs, manages Quality Improvement operations and staff, and coordinates administrative quality data and information for quality committees and the Board of Directors.  Performs complex analysis and leads resolution to operational problems.  Decision making is focused on implementing practical, timely solutions.  Assesses the impact of quality improvement initiatives across TriWest.  Collaborates and develops consensus with senior leadership and staff at all levels.  Communicates and collaborates cross-functionally with a broad scope of project plans and risk management activities.  Operates with a thorough understanding of healthcare business processes, URAC and ISO standards.  Participates in new program development as necessary.
Recruiting Location Phoenix, AZ
ID 2020-3162
Project Specialist 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.   Ensure proper tracking of work requests through completion, identification/documentation of tasks and deliverables from initiatives and projects. Log and track project risks and issues, and other administrative duties supporting department leadership. Supports committee and other meetings as required.
Recruiting Location Phoenix, AZ
ID 2020-3161
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.
Recruiting Location Phoenix, AZ
ID 2020-3159
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 2020-3158
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 2020-3151
This Position is located in Phoenix, AZ   Crisis Clinical – Web Based 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 Crisis Clinical – Web Based?
Recruiting Location Phoenix, AZ
ID 2020-3150
Sr Workload 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.   Are you our next Sr Workload Reporting Analyst?
Recruiting Location Phoenix, AZ
ID 2020-3149
Sr. Communication Specialist 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 Sr. Communication Specialist?
Recruiting Location Phoenix, AZ
ID 2020-3068
This Position is located in Phoenix, AZ Claims Call Center Representative  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 Call Center Rep?
Recruiting Location Phoenix, AZ
ID 2020-3067
This Position is located in Phoenix, AZ   Claims Customer Service Rep 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 Customer Service Rep?
Recruiting Location Phoenix, AZ
ID 2020-3012
This Position is located in Phoenix, AZ Claims Call Center Rep 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 Call Center Rep?
Recruiting Location Phoenix, AZ
ID 2020-3011
This Position is located in Phoenix, AZ   Claims Customer Service Rep 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 Customer Service Rep?
Recruiting Location Phoenix, AZ
ID 2020-2992
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
Recruiting Location Phoenix, AZ
ID 2020-2971
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?  
Recruiting Location Phoenix, AZ
ID 2019-2739
Work Location:  Phoenix, AZ Claims Customer Service Rep 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 Customer Service Rep?