• Lundbeck (Edmond, OK)
    …dynamics, anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid , Commercial) using Lundbeck resources. Pharmaceutical ... Environment/Compliance - Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.… more
    HireLifeScience (07/23/25)
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  • Lundbeck (Raleigh, NC)
    …dynamics, anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid , Commercial) using Lundbeck resources. Pharmaceutical ... Environment/Compliance - Apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED… more
    HireLifeScience (06/26/25)
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  • Daiichi Sankyo, Inc. (Bernards, NJ)
    …of all channels of managed care environment in the US (commercial, Medicare , Medicaid , etc.); preferredSufficient understanding of financial matters to challenge ... and pressure-test assumptions (eg pricing, GTN, etc.). preferred Trave lAbility: to travel up to 10% | Some limited travel for meetings and/or conferences.Daiichi Sankyo, Inc. is an equal opportunity/affirmative action employer. Qualified applicants will… more
    HireLifeScience (06/21/25)
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  • Novo Nordisk Inc. (WA)
    …to: Tax, Trade, Intellectual Property, Supply Chain, Private Health Insurance, Medicare , Medicaid , Reference Pricing, Pricing / Price Increases, Reimbursement, ... Privacy, Labor / Employment Develop NNI's policy positions, in line with Enterprise Strategy Clearly communicate with federal agencies on NNI's positions Educate and enable broader Market Access and Public Affairs Teams, Corporate Tax team, and other NNI… more
    HireLifeScience (06/03/25)
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  • Novo Nordisk Inc. (Traverse City, MI)
    …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription ... Coverage Requirements, Step Therapy, Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses… more
    HireLifeScience (07/17/25)
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  • CenCal Health (Santa Barbara, CA)
    …ensure compliance against requirements including contractual, Federal, State, the Centers for Medicare and Medicaid Services (CMS), and the National Committee ... coordination of internal audits with a focus on Centers for Medicare & Medicaid Services (CMS) requirements. Audits to ensure compliance with Federal and… more
    Upward (07/19/25)
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  • Treasure State Orthotic & Prosthetic Clinic, Inc. (Billings, MT)
    …verification and preauthorization will be daily tasks. A sound foundation in Medicare / Medicaid patient benefit eligibility and coverage a must. Private health ... insurance billing experience would be beneficial. Compensation will depend on experience. Benefits include paid holidays, PTO, 401k plan and profit sharing upon meeting company requirements. Please send cover letter and resume to ###@tsopmt.com recblid… more
    Upward (07/18/25)
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  • Johns Hopkins Healthcare (Springfield, VA)
    …business serving over 500,000 active members with lines of business in Medicaid , Medicare , commercial, military health, health solutions, and venture ... Who you are: As a Field Sales Representative for Medicare Advantage, you are passionate about the health and...have an active Health insurance license and experience selling Medicare in Northern VA. What you'll do: Identify prospective… more
    Upward (07/18/25)
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  • Texas Health Resources (Arlington, TX)
    …and other programs. Oversees or supports departments and entities with various Medicare and Medicaid Supplemental Payment and incentive programs including but ... including but not limited to the review and preparation on of Medicare / Medicaid cost reports, regulation appeals, Disproportionate Share Hospital (DSH), and… more
    Upward (07/02/25)
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  • MBK Senior Living (Scottsdale, AZ)
    …government found not eligible to provide care and services in a facility that receives Medicare or Medicaid funding. If employed at one of our senior living ... communities that receives Medicare or Medicaid funding, team members must not be considered an "Excluded Party" as defined by the US Department of Health and… more
    Upward (07/25/25)
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  • EmblemHealth (New York, NY)
    …of increasing responsibility/complexity/impact. Knowledge of Federal and State Regulations regarding Medicaid , Medicare , Child and Family Health Plus products. ... Deep understanding of direct marketing and sales for Medicare , Medicaid , CHP, and FHP products including targeted population, marketing strategies and budget… more
    Upward (07/19/25)
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  • Tennessee Hospital Association (Brentwood, TN)
    …requirements on hospital reimbursement and methodologies, including, but not limited to, Medicare and Medicaid . 4. Prepares draft letters and position statements ... to state and federal regulatory agencies, including the Centers for Medicare and Medicaid Services (CMS), the Internal Revenue Service (IRS), TennCare waiver… more
    Upward (07/20/25)
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  • CAPPS (San Antonio, TX)
    …or full-time investigations; law enforcement; auditing; accounting; compliance monitoring in Medicaid , Medicare , health care insurance, or closely related ... Job Description GENERAL DESCRIPTION The Medicaid Fraud Control Unit of the Office of...Sergeant whose work will involve advanced criminal investigations of Medicaid provider fraud and nursing home related investigations. Work… more
    Upward (06/26/25)
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  • Sanctuary Hospice (Cleveland, OH)
    …with all hospice-specific regulations, laws, and policies, including those related to Medicare / Medicaid matters. Under the guidance of senior management, you ... Two (2) years of hospice experience required with intimate knowledge of Medicare / Medicaid and Department of Aging and Disability Services regulations. Operations… more
    Upward (07/26/25)
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  • Vail Health Hospital (Vail, CO)
    …Payer Questionnaire for Medicare beneficiaries in accordance with Centers for Medicare & Medicaid Services (CMS) standards Role Models the Principals of ... and other related tasks or requirements by payors, including Medicare , using a variety of computer-based systems. If in...feedback for departmental staff meetings. Follow the Center for Medicare & Medicare Services (CMS) requirements for… more
    Upward (07/01/25)
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  • MBK Senior Living (Mountlake Terrace, WA)
    …government found not eligible to provide care and services in a facility that receives Medicare or Medicaid funding. If employed at one of our senior living ... communities that receives Medicare or Medicaid funding, team members must not be considered an "Excluded Party" as defined by the US Department of Health and… more
    Upward (06/29/25)
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  • StateJobsNY (New York, NY)
    …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... to the degree necessary to allow for your services to be billed through Medicare and Medicaid . If you are appointed and are required to become a Medicare more
    Upward (07/25/25)
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  • The Villages Health (The Villages, FL)
    …detailed instructions on payor-specific application requirements for participation with Medicare , Medicaid , and commercial health plans. Continuously analyzes ... Microsoft Office Word and Excel Complete understanding of major health plans including Medicare , UHC and BCBS Ability to communicate clearly with all levels of… more
    Upward (07/26/25)
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  • Novir (Milwaukee, WI)
    …of experience working with medical billing software Experience working with HIPAA, Medicare and Medicaid regulations High school diploma or equivalent; associate ... billing processes. Experience with insurance systems and payer platforms (eg, Medicare , Medicaid , commercial insurers). Knowledge of vaccination reimbursement… more
    Upward (07/20/25)
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  • MBK Senior Living (Portland, OR)
    …government found not eligible to provide care and services in a facility that receives Medicare or Medicaid funding. If employed at one of our senior living ... communities that receives Medicare or Medicaid funding, team members must not be considered an "Excluded Party" as defined by the US Department of Health and… more
    Upward (07/21/25)
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