- Marshfield Clinic (Marshfield, WI)
- …excluded from participation in any federally funded program, including Medicare and 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 with exclusion or becomes excluded from any federally funded program** **.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative** **Action employer. All… more
- Marshfield Clinic (Ladysmith, WI)
- …excluded from participation in any federally funded program, including Medicare and 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 with exclusion or becomes excluded from any federally funded program** **.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative** **Action employer. All… more
- Aveanna Healthcare (Madison, WI)
- …and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all ... relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more
- GE HealthCare (Waukesha, WI)
- …previous exposure to medical industry regulations (health authority/regulatory, Medicare/ Medicaid Anti-Kickback, Anti-Bribery, Privacy) 6. Previous experience in ... identifying and resolving legal issues quickly and effectively and ability to make on-the-spot risk calls 7. Proven global team leadership experience and ability to function as a senior member of a management team 8. Strong executive presence with outstanding… more
- Molina Healthcare (Kenosha, WI)
- …operational analytics. + Strong understanding of healthcare environments, including ** Medicaid , Medicare, and Marketplace** member and provider engagement models. + ... Demonstrated success in implementing **AI-driven contact center and digital engagement initiatives** , including **Lightico, biometric authentication, and digital ID solutions.** + Financial management experience overseeing budgets, vendor contracts, and… more
- Molina Healthcare (Green Bay, WI)
- …not limited to, phone, chat, email, and off phone work supporting our Medicaid , Medicare and/or Marketplace business. * Conduct varies surveys related to health ... assessments and member/provider satisfaction. * Accurately document pertinent details related to Member or Provider inquiries. * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time… more
- Molina Healthcare (Racine, WI)
- …leadership and quality improvement teams. * Facilitates conformance to Medicare, Medicaid , NCQA and other regulatory requirements. * Reviews quality referred issues, ... focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics… more
- Molina Healthcare (Green Bay, WI)
- …and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, ... educate/consult the health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting * Ability to… more
- Molina Healthcare (Racine, WI)
- …into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced ... analytical work experience within the health care industry (ie, hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving… more
- Marshfield Clinic (Marshfield, WI)
- …excluded from participation in any federally funded program, including Medicare and 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 with exclusion or becomes excluded from any federally funded program** **.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative** **Action employer. All… more