- Humana (Madison, WI)
- …all delivery for their assigned state, supporting the business goals of the Medicaid IT program. + Identifies and implements best practice changes within their ... organization and across Medicaid IT to drive faster and more streamlined delivery...solution recommendations in support of state-level initiatives. + Supports Medicaid IT leadership in preparing readiness review materials. +… more
- Humana (Madison, WI)
- …of financial operations for Humana's Michigan HIDE Plan with a focus on Medicaid and state partnership, oversees the budget, financial reporting, and all audit ... **Key Responsibilities** + Provides market specific financial leadership in the State Medicaid Market, developing a deep understanding of Humana's Medicaid … more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Medicaid Pricing Actuary provides actuarial support across a broad range of actuarial and business ... needs for Medicaid product lines. The Actuary works on problems of...scope and complexity ranging from moderate to substantial. The Medicaid Pricing Actuary may be responsible for any combination… more
- Humana (Madison, WI)
- …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager in ... review and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate advocacy communications,… more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Medicaid Quality Testing Engineer will serve as a technical and strategic leader responsible for ... including requirements gathering, design, implementation, testing, and maintenance. The Medicaid Quality Testing Engineer will provide leadership and mentorship in… more
- Humana (Madison, WI)
- …cost, improving member health outcomes, or otherwise producing value within Humana's Medicaid block of business. Important skills include: - ability to critically ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicaid experience + SAS/SQL experience + Databricks experience + Experience… more
- Humana (Madison, WI)
- …professional associates. This role will lead a small team within the Medicaid Trend Analytics organization responsible for ROI analyses for new operational ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicaid experience + Trend / healthcare analytics experience + Proficiency… more
- Molina Healthcare (WI)
- …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
- Humana (Madison, WI)
- …experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD, MSN, Clinical Certifications, ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Molina Healthcare (Milwaukee, WI)
- …and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks… more