- Prime Therapeutics (Trenton, NJ)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and… more
- Humana (Trenton, NJ)
- …reference sources. Medical Directors will learn Medicare, Medicare Advantage, and Medicaid requirements and will understand how to operationalize this knowledge in ... professionals are in agreement with national guidelines, CMS and state Medicaid requirements, Humana policies, clinical standards, and (in some cases) contracts.… more
- Prime Therapeutics (Trenton, NJ)
- …oversees contracting, rate generation, reporting, and deliverables for State Medicaid supplemental rebate programs. This role collaborates with internal departments ... and external partners, including State Medicaid Programs and pharmaceutical manufacturers, to ensure strategic objectives and contractual obligations are met. This… more
- Humana (Trenton, NJ)
- …health first** The Senior Acquisition Implementation Professional manages all aspects of Medicaid State Implementations, from start to finish, so that it is ... internal stakeholders. The Senior Acquisition Implementation Professional manages all aspects of Medicaid State Implementation, from start to finish, so that it is… more
- Humana (Trenton, NJ)
- …conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid , and Medicare Advantage requirements and will understand how to ... of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/… more
- Penn Medicine (Plainsboro, NJ)
- …Manager of Admissions provide insurance verification and coordination for all commercial, Medicaid and Medicare cases across programs to facilitate patient access to ... managed care companies, benefits and policies for commercial, Medicare and Medicaid populations + Possess significant knowledge of various Union related benefits… more
- Prime Therapeutics (Trenton, NJ)
- …client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned **Education & Experience** + Bachelor's ... within a highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must...study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care Act knowledge and experience **Physical… more
- Genesis Healthcare (Eatontown, NJ)
- …Cycle Management, which includes census, ancillaries, billing, adjustments, deposits, collections, Medicaid Pending and resident funds. The BOM must also have a ... 9. Monitors private spend down and timely conversions to Medicaid Pending; manages Medicaid Pending tracking and...and timely conversions to Medicaid Pending; manages Medicaid Pending tracking and all related processes including county… more
- Cognizant (Trenton, NJ)
- …with stakeholders to design solutions, troubleshoot issues, and ensure compliance with Medicaid and Medicare requirements. **In this role, you will:** + Analyze, ... fee tables, and policy administration. + Experience building solutions for Medicaid QNXT benefit configuration matrix. + Strong troubleshooting skills for claim… more
- Humana (Trenton, NJ)
- …Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care ... formulary management and clinical programming + Represents Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human… more