- Molina Healthcare (Green Bay, WI)
- …programs providing ongoing communication of goals, evaluation, and support to ensure compliance with standardized protocols and processes. + May engage and oversee ... years supervisory/management experience in a managed healthcare environment. + Medicaid/ Medicare Population experience with increasing responsibility. + 3+ years of… more
- CVS Health (Madison, WI)
- …issues. + Manages operational aspects of the team (eg, budget, performance, and compliance ), and implements workforce and succession plans to meet business needs. + ... of 3 years managing/leading a team. + Experience working in Medicare , Medicaid, or Commercial Health Insurance. **Preferred Qualifications** + Experience working… more
- Molina Healthcare (Madison, WI)
- …and supervision of daily functional operations to insure compliance to contract requirements. **Knowledge/Skills/Abilities** * Oversees budget responsibilities ... type management responsibility. 5 years progressive experience supporting a Medicaid,. Medicare and Marketplace or large claims processing environment with… more
- SSM Health (Fond Du Lac, WI)
- …Agnes Hospital **Worker Type:** Regular **Job Summary:** Coordinates regulatory compliance activities. Works collaboratively with leaders, clinicians and other staff ... meet regulatory requirements. Ensures implementation of an integrated regulatory compliance and accreditation program. **Job Responsibilities and Requirements:** PRIMARY… more
- Molina Healthcare (Kenosha, WI)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- Elevance Health (Waukesha, WI)
- …specific understanding in end-to-end claims/ encounter processing, as well as ensuring compliance with Medicare / Medicaid regulatory policies regarding FFS and ... Requires experience using RADV protocols and following Center for Medicare and Medicaid Services (CMS) and Affordable Care Act...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Marshfield Clinic (Weston, WI)
- …Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training… more
- Marshfield Clinic (Marshfield, WI)
- …Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... for billing, internal and external reporting, research and regulatory compliance activities. This individual accurately codes outpatient conditions and procedures… more
- CenterWell (Madison, WI)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- Gentiva (Milwaukee, WI)
- …ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure timely and ... health, or healthcare operations leadership + Strong understanding of hospice regulations, compliance , and Medicare conditions of participation + Proven ability… more