- 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 Clinical Standards and Quality,Clinical ... leading a staff with overall responsibility for leading the development of Medicare and Medicaid quality standards. Responsibilities Direct projects teams to… 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. * ... Staff in our Health unit will eventually work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts will… more
- Humana (Springfield, IL)
- …experience in health care and/or case management. + 1+ years of experience with Medicare & Medicaid recipients and/or long-term care and/or Home and Community ... services, or a related field. + Unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Indianapolis, IN)
- …Case Management, delivery of care for elderly or special needs populations, or in Medicaid and/or Medicare . + 2+ years of management or supervisory experience. + ... Active Registered Nurse (RN) license, licensed Clinical Social Worker (LCSW) or...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Nashville, TN)
- …Commonwealth of Virginia. + Three (3) or more years of managed care experience in Medicare and/or Medicaid , specifically in the delivery of care for elderly or ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- The Cigna Group (Bloomfield, CT)
- …+ Ideal candidate would have previous case management experience with the Medicare / Medicaid population specifically focusing on Special Needs Plan. Model of ... care related field with current licensure. **Job Description** This position, the Nurse Case Manager Senior Analyst, through the case management process, will… more
- Elevance Health (Columbus, OH)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing … more
- Elevance Health (Columbus, OH)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing … more
- State of Georgia (Fulton County, GA)
- …+ Obtains and maintains comprehensive knowledge of operations and reimbursement policies of Medicare and Medicaid programs. + Works with investigative team to ... Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/52416/other-jobs-matching/location-only) Hot… more
- The Cigna Group (Bloomfield, CT)
- …years experience in acute care, home health or case management experience. + Medicare and/or Medicaid experience with geriatric populations a plus + Certified ... Summary:** Delivers specific delegated tasks assigned by a supervisor in the Nurse Case Management job family. Plans, implements, and evaluates appropriate health… more
- Commonwealth Care Alliance (Boston, MA)
- …(5) years of clinical experience in medical or behavioral health care delivery + Medicare and Medicaid managed care experience + Must have experience overseeing ... contractual performance standards. + Experience with managing clinical services for Medicaid / Medicare patients + Demonstrated knowledge of NCQA, federal and… more
- ABCM Corp (Aplington, IA)
- …communication skills specific to the English language + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination is required, with ... Medicare Coordinator - RN - Full-Time ABCM Corporation...hour Summary Under the supervision of the Director of Nursing Services (DON): + Responsible for the Utilization Review… more
- ABCM Corp (Mount Vernon, IA)
- …communication skills specific to the English language + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination is required, with ... Medicare Coordinator - RN/LPN - Day Shift, Full-Time...hour Summary Under the supervision of the Director of Nursing Services (DON): + Responsible for the Utilization Review… more
- ABCM Corp (Nevada, IA)
- …communication skills specific to the English language + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination is required, with ... Medicare Coordinator - RN/LPN - Full-Time ABCM Corporation...hour Summary Under the supervision of the Director of Nursing Services (DON): + Responsible for the Utilization Review… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- …and Medicare Secondary Payer claims for accuracy and timely submission per Medicare , Commercial, and Medicaid billing guidelines + Submission of Medicare ... on unpaid claims and document account within standard billing cycle time frame ( Medicare : 16 days after submission , Commercial/ Medicaid Coinsurance: 14-21 days… more
- Molina Healthcare (Glen Allen, VA)
- …be licensed for the state of VIRGINIA. Manager will support a team of field Nurse Case Managers supporting our Medicaid program We are looking for someone with ... 3+ years supervisory/management experience in a managed healthcare environment. + Medicaid / Medicare Population experience with increasing responsibility. + 3+… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** This position will support our MMP ( Medicaid Medicare Population) that is part of the Community Well Services team. This position will have a ... required. **JOB QUALIFICATIONS** **Required Education** Graduate from an Accredited School of Nursing **Required Experience** + At least 1 year of experience working… more
- The Wesley Community (Saratoga Springs, NY)
- …in a Skilled Nursing facility billing preferred. + Experience in Medicare , Medicaid and Commercial insurance plans required. + Extensive experience with ... Medicare , HMO, VA, MLTC as well as secondary Medicaid claims monthly. + Prepare/submit Wesley Medicare ...+ A 401K retirement plan + Tuition assistance and nursing scholarships + Opportunities for growth and development +… more
- The Buckingham (Houston, TX)
- …functions. Responsibilities: + Maintains current knowledge base of guidelines for Medicare / Medicaid providers. + May conduct pre-admission assessments for ... and bill for services in the licensed and certified nursing center. This person will assist the Director of...MDS assessments prior to final submission to Center for Medicare / Medicaid Services (CMS) using the standard organizational… more