- Public Consulting Group (Madison, WI)
- …. Employee will be responsible for Medicaid , SNAP, WIC and other state government programs . They will be analyzing business requests, making ... + Experience with CMS, Medicaid , SNAP, WICK, and other state government programs **Supervisory Responsibility** + None **Working Conditions** + Remote… more
- Prime Therapeutics (Madison, WI)
- …and drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is...to execute the strategy + Establish key relationships with Government Program owners at the plans, and… more
- Prime Therapeutics (Madison, WI)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... is responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and … more
- Intermountain Health (Madison, WI)
- …Specialist is responsible for supporting and improving the quality performance of Government programs , particularly Medicare, with a strong focus on clinical ... is also tasked with identifying and engaging members in programs that enhance adherence and overall health outcomes, building...constructive and actionable feedback. + Represents the team in government meetings or special projects as assigned by a… more
- Molina Healthcare (Madison, WI)
- …sufficient to meet requirements. + Responsible for reviewing internal dashboard of Value Based Programs & Contracts by state by LOB for assigned markets each ... value-based program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment,… more
- CenterWell (Madison, WI)
- …to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore Coding Operations works on ... caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance...inquiries and issues. + May participate in coder education programs on coding compliance. + Follows state … more
- Humana (Madison, WI)
- …the HOS program in all aspects of Humana's Medicare Advantage government business segment. + Lead and manage strategic initiatives, including the development of ... caring community and help us put health first** The Senior Program Delivery Professional HOS Strategic Initiatives strategically identifies enterprise partners to… more
- Molina Healthcare (Madison, WI)
- …a managed care organization ( Medicaid , Medicare, Marketplace and/or other government -sponsored program ), or medical office/hospital setting. + Completion of ... + Strong understanding of CMS regulations, Medicare MMP regulations and state specific requirements + Impeccable attention to detail + AOR/IRE understanding… more
- Public Consulting Group (Madison, WI)
- …public better. We provide the full spectrum of technology consulting services to help state and local agencies meet operational and program needs that enhance ... * Responsible for organizational migration, gap analysis, and coordination of program improvement, communications, and training activities related to MEMS Modules,… more
- Public Consulting Group (Madison, WI)
- …better serve populations in need by making meaningful and lasting changes in government organizations. Services: + Program Consulting + Finance Consulting and ... and other tools. + Develop expertise in federal and state funding requirements, including Title IV-E, Medicaid ,...strategies. + Ability to interpret and apply federal and state policy to financial planning and program … more
- Sumitomo Pharma (Madison, WI)
- …Disease products to ensure access for patients through various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove ... escalations as needed to ensure timely access for patients + Engage with government stakeholders, including state and federal health agencies, to ensure… more
- Centene Corporation (Madison, WI)
- …preferred)** as a MD or DO without restrictions, limitations, or sanctions from government programs . Pay Range: $221,300.00 - $420,500.00 per year Centene offers ... expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state , corporate, and accreditation… more
- Prime Therapeutics (Madison, WI)
- …Word, and system operations (eg workflow processes and case management) + Government programs (Medicare) knowledge **Preferred Qualifications** + Contact Center ... of business to review the benefits of the MTM program . This position speaks with members to gather and...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Humana (Madison, WI)
- …help us put health first** The Software Engineer 2 within Humana Government Business codes software applications based on business requirements. The Software ... skills and teamwork abilities. + Successfully receive interim approval for government security clearance (NBIS- National Background Investigation Service) + Our… more
- Evolent (Madison, WI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... + **This position is 100% Remote and can be completed from any state . Multiple opportunities for a flexible schedule and both part-time and full-time options… more
- Evolent (Madison, WI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... medical necessity guidelines, as well as other requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
- Evolent (Madison, WI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
- Evolent (Madison, WI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
- Molina Healthcare (Madison, WI)
- …of medical staff services. Maintains a working knowledge of applicable national, state and local laws and regulatory requirements affecting the medical and allied ... of assigned team and responds to inquiries, issues and complaints from government and accreditation regulators. + Directs the team in providing physician leadership… more
- Somatus (Madison, WI)
- …an initial triage assessment to help align patients with the most appropriate program in accordance with program guidelines. + Documents about their activities ... patients of their upcoming appointments. + Helps patients access community and government -based services, including possibly filling out paperwork for the patient. +… more