- Centene Corporation (Frankfort, KY)
- …Job Description **Centene is hiring a Remote Psychologist - Join Our Kentucky Medicaid Team!** **Are you a licensed Psychologist with a Kentucky license with a ... looking for a Remote Psychologist to support our Kentucky Medicaid plan. In this role, you'll play a key...and utilization management processes + Interact with the Medical Director , or designee, to discuss clinical authorization questions and… more
- Intermountain Health (Frankfort, KY)
- …and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health Professionals. **Essential Functions** + Participates ... payer re-credentialing requests and demographic/roster requests. + Completes out-of-State Medicaid individual and facility enrollments timely and accurately for… more
- Humana (Frankfort, KY)
- …of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid , and other health plans to millions. By integrating insurance with care ... plays a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's total revenue and earnings.… more
- Humana (Frankfort, KY)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of healthcare records +… more
- Molina Healthcare (Owensboro, KY)
- …evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has decision-making accountability for ensuring ... Healthcare or Operational experience in related job. + 2 years minimum in Director level role or above. + Extensive understanding of Medicare Advantage, ACA and… more
- Signature Healthcare (Elizabethtown, KY)
- …have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great Place to Work ... of Signature centers are earning Five-Star ratings from the Centers for Medicare & Medicaid Services. We were also named one of Modern Healthcare's "Best Places to… more
- Humana (Frankfort, KY)
- …Complete a monthly report of Adult Guardianship Cases, that goes to our BH Director and ultimately KDMS + Attend in-person quarterly meetings at Humana corporate in ... members under state guardianship + CCM certification + Knowledge of KY Medicaid state contract, community health and social service agencies and additional community… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Sr. Product Manager ... Ability to interpret regulatory guidelines from CMS, Tricare, and Medicaid websites + Ability to understand the vocabulary used...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Molina Healthcare (KY)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation...+ 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis,… more
- Signature Healthcare (Louisville, KY)
- …have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great Place to Work ... of Signature centers are earning Five-Star ratings from the Centers for Medicare & Medicaid Services. We were also named one of Modern Healthcare's "Best Places to… more