- Novo Nordisk Inc. (Ann Arbor, MI)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... computer skills required (Windows, Word, Excel); Prior computer experience using sales data /call reporting software ideal Must be a self-starter and be able to… more
- DATAMAXIS (IL)
- … Medicaid agencies or equivalent supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems. + ... Understanding of claims, recipient/eligibility, and provider/enrollment data processes. + Able to create and perform ...datasets. + Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered. +… more
- New York State Civil Service (Albany, NY)
- …Managed Care and Data Platform Unit is recruiting to fill TWO Medicaid Integrity Specialist 1 Trainee positions, which will be tasked with duties ... Medicaid Inspector General, NYS Office of the Title Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 (NYHELPS)...to find fraud, waste, and abuse in the NYS Medicaid Data Warehouse, and potentially use other… more
- City of New York (New York, NY)
- …ELIGIBLE FOR CONTINUED EMPLOYMENT. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and ... Assisted Living Program, Care at Home Program and Homebound Medicaid . The Medicaid Eligibility Unit is responsible...and various external program applications, such as the Eligibility Data Image Transfer System (EDITS) Plus, the HRA One… more
- Wellpath (Hendersonville, TN)
- …education, and point of care support. **How you make a difference** The Senior Medicaid Support Specialist provides guidance and technical support to field staff ... financial impacts, preventing unnecessary offsite costs, and supporting compliance with Medicaid billing standards. The specialist assists with developing,… more
- Genesis Healthcare (PA)
- …complexities of Medicaid eligibility? Then join us as a Regional Floating Medicaid Application Specialist . In an assigned geography, you will improve the ... and clinical eligibility requirements, asset limits, and state-specific long-term care Medicaid rules. *Monitor key performance indicators, analyze data , and… more
- Commonwealth Care Alliance (Boston, MA)
- …that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and ... necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance...and report outcome results on edits implemented. + Utilize data to examine large claims data sets… more
- Synergy Healthcare Solutions (Dunwoody, GA)
- …Remote | 1040 Crown Pointe Pkwy, Dunwoody, GA, USA **A/R Billing and Collections Specialist - Medicaid (Atlanta, GA based)** **Position is hybrid with the ... over 1,500 courses for senior care, health and human services industry. Data base includes, MS Office and Leadership/Supervisory content. Available via computer or… more
- Centene Corporation (Jefferson City, MO)
- …experience required. + Excellent Microsoft Office skills and experience with data analytics preferred. Certified in HealthCare Compliance (CHC) preferred. Certified ... Compliance & Ethics Professional (CCEP) preferred. Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off… more
- City of New York (New York, NY)
- …and services. The Office of Constituent Services is recruiting for eleven (11) Eligibility Specialist II's to function as a Medicaid Helpline Agents in the DSS ... BECOMES AVAILABLE, TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. The Medicaid Helpline provides information to New Yorkers on enrolling...from the client regarding their case. - Review pertinent data from New York State EMEDNY system in order… more
- MSys Inc. (Raleigh, NC)
- …go for 4+ years Hybrid seeks a Pharmacy Benefits Administrator (PBA) Product Integration Specialist to join the Medicaid Enterprise System (MES) project. The PBA ... Job summary: Title: Medicaid Pharmacy Analyst- Hybrid Location: Raleigh, NC, United...in 5 Years + Experience handling HIPPA and PII data 5 Years + Managed care knowledge or experience… more
- City of New York (New York, NY)
- … program and services. The Office of Constituent Services is recruiting for an Eligibility Specialist II to function as a Medicaid Helpline Agent in the DSS ... call center. OCS is recruiting for fifteen (15) Eligibility Specialist II to function as Infoline/ Medicaid Helpline...from the client regarding their case. - Reviews pertinent data from New York State EMEDNY system in order… more
- HCA Healthcare (Houston, TX)
- …is recognized. Submit your application for the opportunity below:Certified Oncology Data Specialist . **Benefits** Parallon, offers a total rewards package ... vary by location._** We are seeking a Certified Oncology Data Specialist for our team to ensure...cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon… more
- NHS Management, LLC (Birmingham, AL)
- …experience along the way. We are in search of a qualified Finanical Specialist Assistant: To perform the successful and timely completion of assigned business and ... quality of the business office. + Reviews, analyzes and interprets financial data to monitor progress toward established goals; identifies deterrents to success and… more
- Idaho Division of Human Resources (ID)
- Quality Assurance Specialist - MED Posting Begin Date: 2025/05/23 Posting End Date: 2025/06/05 Category: Medical Sub Category: Community Services Work Type: Full ... The Idaho Department of Health and Welfare's Division of Medicaid , Bureau of Long Term Care has an exciting...innovative team member to join us as aQuality Assurance Specialist . This position will work directly with service providers,… more
- City of New York (New York, NY)
- …self-sufficiency. The Fair Hearing Process Specialist prepares Public Assistance/SNAP/ Medicaid eligibility forms by incorporating all received data and ... and to promote individual and family self-sufficiency. Also prepares Public Assistance/SNAP/ Medicaid eligibility forms by incorporating all received data and… more
- MyFlorida (West Palm Beach, FL)
- INVESTIGATION SPECIALIST II - 60039315 Date: Jun 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 853416 Agency: Children and Families Working Title: INVESTIGATION SPECIALIST II - 60039315 Pay Plan: Career Service Position Number: 60039315… more
- Outreach Development Corporation (Richmond Hill, NY)
- …more information, please visit www.opiny.org. Position: Medical Billing & Collections Specialist Position: The medical billing and collections specialist ... In this role ongoing attention to regulatory changes in Medicaid and other public assistance programs as well as...is essential. Position 1 : Medical Billing & Collections Specialist Position Summary: + Compile, monitor and bill out… more
- Bayer (NJ)
- …minds to make a real difference, there's only one choice.** **Product Specialist (Model N)** **YOUR TASKS AND RESPONSIBILITIES** The primary responsibilities of this ... role, Model N Product Specialist are to: + Perform support of Model N...Perform support of Model N regulatory modules (Government Pricing, Medicaid ) + Participate in the implementation of Model N… more
- University of Colorado (Aurora, CO)
- **Peer Recovery Specialist Patient Services** **Description** **University of Colorado Anschutz Medical Campus** **School of Medicine | Department of Psychiatry | ... Services (ARTS) | Adult Outpatient Program** **Job Title: Peer Recovery Specialist - Patient Services** **Position: #00828232 - Requisition: #35187** **Job… more
