- Humana (Beloit, WI)
- …payer sources, providers, and interdisciplinary care teams. + Educates members in maintaining Medicaid eligibility . + Assist with entry of annual Level of Care ... + Two (2) years of prior experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), and/or managed… more
- CVS Health (WI)
- …And we do it all with heart, each and every day. **The Medicaid Senior Manager, Network Management:** + Negotiates, executes, conducts high level review and ... Office suite applications (eg, Outlook, Word, Excel, etc.). + Knowledge of Medicaid programs. + Solid decision-making skills while executing national, regional, and… more
- CVS Health (WI)
- …reconciliation reports received from Finance + Responds, researches, and resolves eligibility related issues involving member specific information + Applies all ... legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters. + Validates benefit plan enrollment information for… more
- Gentiva (Milwaukee, WI)
- …+ Understanding of palliative medicine principles, home health, hospice care eligibility , and Medicare/ Medicaid regulations. + Familiarity with the ... interdisciplinary care process. + Meets mandatory continuing education requirements for Gentiva and licensing boards. + Proficient in point-of-care software and technology. **Education/Experience:** + Master of Science in Nursing from an accredited school of… more
- Molina Healthcare (WI)
- …+ Health claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims ... and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution… more
- Marshfield Clinic (Weston, WI)
- …and determine level of financial assistance award, and medication assistance eligibility , according to protocol. The Patient Assistance Counselor maintains a ... + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training offered after… more
- Molina Healthcare (Oshkosh, WI)
- …sales and marketing of Molina Medicare products to dual eligible, Medicare- Medicaid recipients within approved market areas to achieve stated revenue, profitability, ... the product choices available to them, the enrollment process ( eligibility requirements, Medicare review/approval of their enrollment application, timing of… more
- Elevance Health (Waukesha, WI)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- Elevance Health (Waukesha, WI)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The **Audit and Reimbursement III** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- Elevance Health (Waukesha, WI)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement II** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more