- CVS Health (Moon Township, PA)
- …variety of enrollment questions or concerns. Maintains enrollment data in eligibility systems to ensure compliance with CMS guidance requirements. Required ... Supervisor + Keep a positive attitude as changes occur Preferred Qualifications + Medicare industry experience + Familiarity with Medicare Enrollment systems +… more
- CVS Health (Columbia, SC)
- …enrollment related issues/requests involving member specific information -The eligibility Consultant must have a full understanding of Medicare Guidelines ... care more personal, convenient and affordable. Position Summary - As an Eligibility Consultant you will respond, research, and resolve eligibility and other… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Medicare Health Plan Operations Specialist - Remote **Job Description** The Associate Functional ... Business Consultant serves as a business system or business process...one of the specific areas for position (eg, claims, eligibility , product, benefits, implementations or area related to the… more
- CVS Health (Harrisburg, PA)
- …hours when needed during weekdays and on the weekends Preferred Qualifications Medicare knowledge and working experience EducationHigh School Diploma or GED Pay ... Range The typical pay range for this role is: $17.00 - $29.88 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a… more
- Mathematica (Columbus, OH)
- …care workforce, and quality monitoring is also preferred. Understanding of dual Medicare -Medicaid eligibility and coordination is preferred, but not required. * ... related field; and 5 or more years of experience ( Consultant ) or 7/+ years of experience (Sr. Consultant...work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts… more
- WellSense (Boston, MA)
- Provider Relations Consultant (Boston/Northeast MA) - $5,000 sign on bonus! WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25...no matter their circumstances. As a WellSense Provider Relations Consultant , you'll act as the primary liaison between WellSense's… more
- MyFlorida (Fort Pierce, FL)
- …Ensures that any applicable hierarchy of payer sources is used appropriately. Screens for Medicaid eligibility , PAC Waiver eligibility , Medicare A, B, and D ... OPERATIONS & MGMT CONSULTANT II - SES - 64004774 Date: May...Staff Monitors compliance with Ryan White Part B Client Eligibility Protocols, and medical case management program policies, procedures,… more
- CVS Health (Harrisburg, PA)
- …and affordable. Position SummaryThis position is responsible for the processing of Medicare members eligibility discrepancies between the Medicare Enrollment ... Plan System and the Centers for Medicare and Medicaid (CMS) utilizing policy guidelines and experience of member enrollment rules. The primary focus will be on the MAPD/Aetna line of business, but not limited to that as the team is also responsible for… more
- Wipfli LLP (Spokane, WA)
- …make a difference, Wipfli is the place for you. Responsibilities: + Prepare Medicare /Medicaid cost reports and payment reconciliations for a variety of providers and ... long-term care, pet insurance, ID theft protection, and supplemental life/AD&D. Eligibility for all benefits programs is dependent on annual hours expectation,… more
- MetroLink (Los Angeles, CA)
- …with a Commuter/Passenger or Class 1 Freight Railroad or as a consultant or contractor working on long-term assignments involving Commuter/Passenger or Class 1 ... if he/she is covered under a SCRRA health plan. Eligibility begins the first of the month following hire...exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is… more
- Silicon Valley Power (Santa Clara, CA)
- …communication skills; a proven record of preparing and administering consultant contracts and agreements; experience preparing construction documents; experience ... for water and sewer projects. As well as procures consultant and construction contracts for the design and construction...law requires all employees to provide verification of their eligibility to work in this country. Please be informed… more
- Silicon Valley Power (Santa Clara, CA)
- …track record of designing and delivering utility projects and administering consultant and construction contracts. The qualified candidate will have experience ... systems * Provide construction management, construction contract administration, and consultant contract administration for public works projects * May prepare… more
- HCA Healthcare (Brentwood, TN)
- …but are not limited to: MACRA/MIPS, 21st Century CURES, Centers for Medicare and Medicaid Innovation (CMMI) projects; Accountable Care Organizations (ACO); Advanced ... Alternative Payment Models (AAPM); Medicare Advantage; and commercial payer value programs. This position...the evaluation and management of provider and entity (TIN) eligibility for government and other payer programs. This position… more
- SUNY Upstate Medical University (Syracuse, NY)
- … Enrolled with Medicare Identification Number (or PTAN) OR be eligible for Medicare Enrollment within 6 months of hire ( eligibility criteria for NP requires ... their scope of practice. TEACHING AND STAFF DEVELOPMENT 1. Acts as a consultant to nursing staff and when appropriate participates in inservice training for the… more
- NHS Management, LLC (Daytona Beach, FL)
- …other business office related tasks, including but not limited to: + Medicaid, Medicare and/or secondary billing + Assist with evaluation and selection of all ... application process and timely submission to prevent delays in the attainment of eligibility and payment. Process to include: + Meeting with family and or resident… more
- Virginia Mason Franciscan Health (Gig Harbor, WA)
- …FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility , and more! **Responsibilities** **Franciscan Medical Group, a part of ... up of the patient's primary care provider, a psychiatric consultant and, when available, other providers in the primary...hire. + Eligible to be credentialed and enrolled in Medicare and private payers for reimbursement. **Pay Range** $35.28… more
- MyFlorida (Fort Pierce, FL)
- …Ensures that any applicable hierarchy of payer sources is used appropriately. Screens for Medicaid eligibility , PAC Waiver eligibility , Medicare A, B, and D ... Program Office. This position reports to the Operations Management Consultant II Completes comprehensive Needs Assessments of individuals presenting themselves… more
- Billings Clinic (Billings, MT)
- …and Transformation Division of Billings Clinic. The Healthcare Quality Improvement Consultant serves as a subject matter expert regarding the continual analysis, ... and infection prevention system applications. The Healthcare Quality Improvement Consultant operates as a subject matter expert in federal,...commercial programs such as: * o CMS (Centers for Medicare and Medicaid Services) * o DNV (Det Norske… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, ... (2) direction of graduate theses in economics, or (3) service as a consultant or advisor on technical economics problems. TRANSCRIPTS are required to verify… more
- Elevance Health (Denver, CO)
- …a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid ... be responsible for appeals reviews within our Medicaid and Medicare programs.** The **Behavioral Health Medical Director** is responsible...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more