- Public Consulting Group (Jefferson City, MO)
- …. 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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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
- CenterWell (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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
- Centene Corporation (Jefferson City, MO)
- …investigations and reporting meet federal and state mandates, including CMS and state Medicaid program requirements. + Oversee the intake, triage, ... regulatory enforcement required. + Significant experience managing large-scale FWA programs in a health plan, payer, government ...consulting firm required. + Deep knowledge of federal and state health programs (Medicare, Medicaid )… more
- Public Consulting Group (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …as a MD or DO without restrictions, limitations, or sanctions from government programs . Centene offers a comprehensive benefits package including: competitive ... expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state , corporate, and accreditation… more
- Centene Corporation (Jefferson City, MO)
- …Federal laws, rules and regulations preferred + 1+ years experience in State Medicaid or Federal managed care compliance preferred **Licenses/Certifications:** ... to maintain integrity through oversight and monitoring and in meeting Government -sponsored health care program requirements. + Intakes and triages… more
- CVS Health (Jefferson City, MO)
- …**Preferred Qualifications** + Experience working with healthcare payors and/or government programs such as Medicare and Medicaid + CPA License + SQL ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation… more
- Prime Therapeutics (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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
- Datavant (Jefferson City, MO)
- …health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining ... coding. + Experienced in HCC coding across Medicare, commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, abbreviations, pharmacology, and… more