- Merck & Co. (North Wales, PA)
- …agency partners and focus on customer segments (eg health plans, Medicare, Medicaid , federal, pharmacy, hospital, Group Purchasing Organization s, etc.). Primary ... your employment may pose an undue burden to business operations , in which case you may not be offered...race, color, age, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status, or… more
- Accounting Now (Pinellas Park, FL)
- …documenting related account activities, posting adjustments and collections of Medicare, Medicaid , Medicaid Managed Care, and commercial insurance payers. The ... specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment… more
- Option Care Health (Springfield, IL)
- …conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for ... but not limited to fraud, waste and abuse; Medicare & Medicaid billing requirements; and interactions with healthcare professionals.Understand macro and micro… more
- Volunteers of America Mid-States (Louisville, KY)
- …from $55,000-$65.925 INTRODUCTION: Volunteers of America Mid-States (VOA) is a non-profit organization spanning four states that creates positive change in the lives ... fund matching Employee discounts *Loan forgiveness options through federal programs ( National Health Corp & Public Service Loan Forgiveness) *All company paid… more
- Volunteers of America Mid-States (London, KY)
- …Family Connections INTRODUCTION: Volunteers of America Mid-States (VOA) is a non-profit organization spanning four states that creates positive change in the lives ... fund matching Employee discounts *Loan forgiveness options through federal programs ( National Health Corp & Public Service Loan Forgiveness) *All company paid… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …fails.seek to always be better tomorrow than today. Organization ExpectationsQuest: Demonstrates/utilizes Quest tools in department.Talent Development: Coaches ... Indicators (KPI)Identifies unit/department level goals that align with the organization 's Key Performance Indicators. HIPAA (Health Insurance Portability and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …fails.seek to always be better tomorrow than today. Organization ExpectationsQuest: Demonstrates/utilizes Quest tools in department.Talent Development: Coaches ... (KPI) Identifies unit/department level goals that align with the organization 's Key Performance Indicators. HIPAA (Health Insurance Portability and Accountability… more
- CVS Health (Hartford, CT)
- …reporting to a Regional CMO of Medicaid , will collaborate with Aetna National Medicaid , Regional and health plan leadership to identify, develop, implement, ... LTSS RFP submissions and provide strategic guidance supporting initiatives across the national Medicaid LTSS line of business including but not limited to… more
- Humana (Louisville, KY)
- …first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy Organization in order to support the strategic direction ... and growth of the Medicaid and Duals lines of business. This is a...that delight key customers and support sustainable health plan operations . + Lead product and benefit filing efforts with… more
- Sumitomo Pharma (Columbus, OH)
- …language clauses. + Keep current on regulatory and industry changes that may impact Medicaid operations . + Oversee the Medicaid Dispute Resolution process. + ... with 2-3 days a week required in office. **Job Duties and Responsibilities** + Lead operations person for all Medicaid decisions as it relates to Model N… more
- CVS Health (Falls Church, VA)
- …you will have the opportunity to engage with stakeholders from Actuarial, Finance, Medicaid Operations , Government Relations, and other areas, as well as with ... convenient and affordable. Position SummaryAetna is recruiting a Lead Director on the Medicaid Actuarial Growth and Strategy team. As Lead Director, you will play a… more
- Humana (Columbus, OH)
- …the Enterprise; leverage these relationships in helping to drive innovation and effective operations for Humana Medicaid . **Use your skills to make an impact** ... Eastern Standard Time Zone** + Bachelor's Degree or 5+ years of Medicaid managed care, network contracting, network/provider operations , and/or provider… more
- UNC Health Care (Holly Springs, NC)
- …Communication skills. **Job Details** Legal Employer: NCHEALTH Entity: Shared Services Organization Unit: Medicaid Eligibility Work Type: Full Time Standard ... **Description** Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique… more
- Public Consulting Group (Columbus, OH)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... the public sector. To learn more, visit www.publicconsultinggroup.com. **Responsibilities** The Medicaid marketplace is changing, and PCG is at the forefront. We… more
- CVS Health (Hartford, CT)
- …a high performing, high quality risk adjustment talent pool that is respected within Medicaid Operations . + Develop the skills and abilities of all team members ... reports including any enhancements. + Utilize data analyses using national tools in conjunction with the corporate lead to...2+ years of experience in the health care industry, Medicaid operations , risk adjustment, or medical coding… more
- Mathematica (Columbus, OH)
- …successfully improving state Home- and community-based services within the state's Medicaid or HCBS administrative agencies such as health, human services, area ... workforce, and quality monitoring is also preferred. Understanding of dual Medicare- Medicaid eligibility and coordination is preferred, but not required. * Duties… more
- CVS Health (Austin, TX)
- …recent and related experience in Provider Operations , Provider Relations or Network operations .- 1+ years of experience in Medicaid and/or Medicare provider ... be a remote position preferred hybrid in Texas** - Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid … more
- Humana (Columbus, OH)
- …practice management. + Utilization management experience in a medical management review organization , such as Medicare Advantage, managed Medicaid , or Commercial ... procedures, processes, productivity targets, and new delivery models. Maintains efficient operations while ensuring attainment of quality of care and financial… more
- Deloitte (Portland, OR)
- …(HCBS) or Long-Term Services and Supports (LTSS) + Project Management + Medicaid Policy and Operations Qualifications Required: + Bachelor's degree required ... Services (HCBS) or Long-Term Services and Supports (LTSS) + Project Management + Medicaid Policy and Operations For individuals assigned and/or hired to work… more
- CVS Health (Scottsdale, AZ)
- … Medicaid requirements across the business + Performing business operations walkthroughs and reviewing risk assessments while participating in annual monitoring ... AZ location CVS Health is seeking a Senior Analyst, Medicaid Compliance Monitoring and Auditing to join our Center...addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our… more
