- Idaho Division of Human Resources (Caldwell, ID)
- Medicaid Program Specialist - MED Posting Begin Date: 2025/10/30 Posting End Date: 2025/11/06 Category: Records Management Work Type: Full Time Remote: ... SOON AS POSSIBLE TO BE CONSIDERED.* The Division of Medicaid , Bureau of Care Management (BCM) has an exciting...team monitoring performance and customer care of a dynamic program that interacts with other IDHW programs, care providers,… more
- HCA Healthcare (Caldwell, ID)
- …you want to join an organization that invests in you as aPatient Collections Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Prime Therapeutics (Boise, ID)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...of business to review the benefits of the MTM program . This position speaks with members to gather and… more
- Molina Healthcare (Nampa, ID)
- …managed care organization ( Medicaid , Medicare, Marketplace and/or other government-sponsored program ), or medical office/hospital setting. * Completion of a ... accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for the comprehensive… more
- Molina Healthcare (Nampa, ID)
- …managed care organization ( Medicaid , Medicare, Marketplace and/or other government-sponsored program ), or medical office/hospital setting. * Completion of a ... the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and… more
- Intermountain Health (Boise, ID)
- **Job Description:** The Pharmacy Government Stars Specialist is responsible for supporting and improving the quality performance of Government programs, ... physicians, and working with pharmacies to prevent delays in medication access. The specialist is also tasked with identifying and engaging members in programs that… more
- Evolent (Boise, ID)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional ... implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a...or sanction by any state or federal health care program , including Medicare or Medicaid , and is… more
- Molina Healthcare (Nampa, ID)
- …(s) proficiency. **Preferred Qualifications** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), ... with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other… more
- Molina Healthcare (Nampa, ID)
- …* Microsoft Office suite proficiency (including Excel), and applicable software program (s) proficiency. Preferred Qualifications * Certified Coding Specialist ... diagnosis-related group (DRG) validation tools and process improvements - ensuring that member medical claims are settled in a timely fashion and in accordance with… more