- SSM Health (Fond Du Lac, WI)
- …knowledge of all The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS) Conditions of Participation and State Hospital Licensing Act standards ... readiness related to The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Conditions of Participations (CoPs) and State specific regulations.… more
- Molina Healthcare (Madison, WI)
- …with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional ... Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract… more
- Prime Therapeutics (Madison, WI)
- …Management organization, or within a highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must be eligible to ... in related area of study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care Act knowledge and experience **Physical Demands** + Ability to… more
- Molina Healthcare (Green Bay, WI)
- …analysis across multiple states and lines of business (Medicare, Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing health care ... Advantage members, the HHS model for Commercial ACA members, the CDPS model for Medicaid members, and others as needed + Must have a strong attention to detail… more
- Molina Healthcare (Racine, WI)
- …performance and quality levels exist in line with Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements. + Monitor and support sales and ... retention efforts. + Monitor compliance and regulatory risks. + Contribute to and present in market performance review meetings. + Collaborate with Network teams on value-based services. + Partner with Government Contracts on regulatory items + Under the… more
- Molina Healthcare (Madison, WI)
- …as provide oversight, including service level agreements. + Collaborates with Medicaid business development and market leadership on mutual growth opportunities. + ... Works with senior management to mitigate risk and develop/implement improvements for all operational areas that impact duals performance. + Collaborates with compliance to ensure appropriate oversight/internal audits; develop leading indicators and alerts for… more
- Mayo Clinic (Eau Claire, WI)
- …service.. Must be able to work independently as needed. Knowledge of Medicare, Medicaid and/or private insurance billing preferred with attention to detail. Able to ... perform all duties to be on call for needed items (Oxygen, BiPAP w/back up, suction, etc.) Physical and mental stamina to be able to withstand what can often be a fast-paced, stressful environment; potentially on feet 90-100% of the time or driving 90-100% of… 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
- 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
- Humana (Madison, WI)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more