• Senior Investigator, Special Investigations Unit…

    CVS Health (Austin, TX)
    …at quarterly state meetings. **Required Qualifications** - 1+ years' experience working with Medicaid . - 3+ years' in healthcare field working in fraud, waste and ... arbitrations, depositions, etc. **Preferred Qualifications** - Knowledge of New Jersey Medicaid - Credentials such as a certification from the Association of… more
    CVS Health (12/10/25)
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  • Remote Call Center Customer Service Representative

    Conduent (TX)
    …is noticed and valued every day. **Remote - Call Center Customer Service Representative** ** Medicaid Member Support - Tier 1** **For The State of Iowa** **You Need ... initial point of contact for inquiries from potential and existing Iowa Medicaid Program recipients and affiliates. + Provide one-to-one telephone contact with… more
    Conduent (12/10/25)
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  • Senior Analyst, Provider Compliance

    CVS Health (Austin, TX)
    …day. **About the Role** We are seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across our organization. In ... Leads and ensures the delivery of high-quality internal and external Medicaid provider audit results, regulatory compliance activities, and proactive risk mitigation… more
    CVS Health (12/10/25)
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  • Senior Medical and Financial Risk Evaluation…

    Humana (Austin, TX)
    …of or the ability to gather knowledge on Medicare Advantage and Medicaid State Regulations + Certified Professional Coding (AAPC) + Previous experience working ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal… more
    Humana (12/09/25)
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  • Medical/Financial Risk Evaluation Professional 2

    Humana (Austin, TX)
    …and abuse within the healthcare industry + Knowledge of the Medicare and Medicaid programs + Experience in data analysis + Must be passionate about contributing ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal… more
    Humana (12/09/25)
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  • Clinical Account Director - Remote

    Prime Therapeutics (Austin, TX)
    …member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the client regarding ... experience + Knowledge of the applicable line of business (eg, Medicare, Medicaid , Exchange, Commercial, Employer Group) Every employee must understand, comply with… more
    Prime Therapeutics (12/07/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (TX)
    …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
    Molina Healthcare (12/07/25)
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  • Strategy Advancement Advisor

    Humana (Austin, TX)
    …Segment team is an entrepreneurial, multi-functional team within Humana's Medicare and Medicaid business unit. The team is focused on driving industry leading ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal… more
    Humana (12/07/25)
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  • Healthcare Staffing Specialist

    Aveanna Healthcare (Addison, TX)
    …an after-hours on-call schedule. Note:As an employer receiving Medicare and Medicaid funds, employees must comply with all health-related requirements in relevant ... Aveanna's supportive and dynamic environment. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
    Aveanna Healthcare (12/06/25)
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  • Senior Analyst, Quality Analytics & Performance…

    Molina Healthcare (San Antonio, TX)
    …automated analytical as well as Reporting modules related to Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. + Analysis and reporting related to Managed ... Review tracking, Interventions tracking for at least one line of business among Medicaid , Marketplace and Medicare/MMP. + 3+ Years of experience in working with… more
    Molina Healthcare (12/05/25)
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