Sam Holmes Email & Phone Number

Minneapolis, Minnesota, United States

Responsible to oversee internal encounters processes on a weekly, monthly and quarterly basis per a defined and regimented schedule. Reconcile between systems and data sources to ensure accuracy and completion of encounter submissions. Subject matter expert on encounters including datasets for submissions, reporting and remediation. Lead the strengthening.

Greater Minneapolis-St. Paul Area

This position is responsible to manage CCO department collaboration tools, processes and related reporting in alignment with department plans, goals and objectives. Act as department single point of contact for collaboration applications including, but not limited to SharePoint and ServiceNow. Act as knowledge manager, ensuring the appropriate collection.

Minneapolis

This position is responsible to ensure technology efforts that support organizational and departmental strategic plans, regulatory directives, operational initiatives and health care reforms meet deadlines and deliver agreed upon functionality. Direct the actions of the Reporting & Quality Assurance (RQA) Team to ensure new or revised benefit and pricing.

Minneapolis

Responsible for managing UCare’s provider network data and reporting requirements as identified for both internal and external stakeholders. Supports efforts to evolve an efficient provider data infrastructure (e.g. business rules, processes, technology, etc.) required to respond to regulatory requirements and guide strategic decision-making. Develop and.

Greater Minneapolis-St. Paul Area

This position is responsible to create Provider Network reports for various regulators (DHS, CMS, and MDH). Create PCNLs (Primary Care Network Listing), Provider Directories and policies; conduct audits of provider demographic information. Collaborate with Government Relations on regulatory audits and RFPs related to provider networks, access &.

Greater Minneapolis-St. Paul Area

Responsible for all aspects of the credentialing and recredentialing processes per NCQA, CMS and MDH Standards for all contracted providers. The application process includes maintenance of the online application site and forms repository and intake, review and appropriate routing of all credentialing documents. This position liaises with both internal and.

Greater Minneapolis-St. Paul Area

Receives and processes review requests or admission notifications from physicians, vendors and facilities. Provides live telephonic access for providers and internal customers. Performs data entry in support of the review activities of each business unit in the department.

Greater Minneapolis-St. Paul Area

Perform a variety of support functions for the Claims Department including: sort and count incoming mail; scan documents and various other UCare correspondence for a variety of departments into the imaging system including Enrollment applications and claims.. File claims; retrieve claims; enter claims, correspondence, Enrollment applications, documents..