- Highmark Health (Madison, WI)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Madison, WI)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Prime Therapeutics (Madison, WI)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Humana (Madison, WI)
- …community and help us put health first** Humana is seeking a Provider Contracting Manager to join the Wisconsin Medicaid Market (iCare) team. The Provider ... and executing provider contracts and agreements for Humana's Wisconsin Medicaid Market (iCare). The Provider Contracting Manager ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Prime Therapeutics (Madison, WI)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Humana (Madison, WI)
- …caring community and help us put health first** Humana/iCare is seeking a Case Manager /Care Coach to join the growing Milwaukee County team in the Family Care ... Partnership (FCP) program. The FCP Case Manager /Care Coach provides care management services through the FCP program including assessment, service plan development,… more
- Pearson (Madison, WI)
- …path through this shifting environment to achieve continued success.** _Purpose Summary_ _The Medicaid and Vendor Implementation Manager will act as the main ... Pearson Virtual Schools' Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing… more
- Molina Healthcare (Madison, WI)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- Prime Therapeutics (Madison, WI)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Walgreens (Schofield, WI)
- …growing the business at the site. Performs all duties of the Pharmacy Manager in their absence **.** **Customer Experience** + Ensures that store personnel provide ... eligibility and all required reporting and documentation. + Responsible for ensuring compliance of team members with regard to the documentation of patient… more
- Humana (Madison, WI)
- …our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing a comprehensive, ... holistic approach for case management throughout the continuum of care. The case manager will offer guidance. support, and coordination of the beneficiary's care as… more
- CenterWell (Madison, WI)
- …part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to ... and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and… more
- Marshfield Clinic (Beaver Dam, WI)
- …. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... support the most exciting missions in the world!** **Job Title:** Manager Home Health/Hospice **Cost Center:** 351011118 BDHos-Home Health **Scheduled Weekly… more
- Humana (Madison, WI)
- …our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. ... The Senior Data Manager work assignments involve moderately complex to complex issues...Migration -- Planning and executing data migration projects. + Compliance -- Ensuring compliance with data protection… more
- Marshfield Clinic (Beaver Dam, WI)
- …. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... the most exciting missions in the world!** **Job Title:** Manager CBRF/RCAC **Cost Center:** 351011460 Beaver Dam-CBRF-Remembrance **Scheduled Weekly Hours:**… more
- Humana (Madison, WI)
- …organization and will be critical in our growth plans. The Principal Product Manager Leads all phases of the product life cycle, from inception to introduction ... Curiosity and a human-centered approach will drive the Product Manager to find relevant data and turn it into...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Marshfield Clinic (Park Falls, WI)
- …. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... to support the most exciting missions in the world!** **Job Title:** Manager - System Biomedical **Cost Center:** 101651034 System Support-Biomed **Scheduled Weekly… more
- Marshfield Clinic (Weston, WI)
- …. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... the most exciting missions in the world!** **Job Title:** Lab Operations Manager - East **Cost Center:** 301691161 WesHos-Laboratory **Scheduled Weekly Hours:** 40… more
- Marshfield Clinic (Marshfield, WI)
- …. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... the most exciting missions in the world!** **Job Title:** RN Case Manager - Rehab Liaison **Cost Center:** 301351181 MfdHos-Rehab Unit-5W **Scheduled Weekly Hours:**… more
- Humana (Madison, WI)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more