- Sumitomo Pharma (Madison, WI)
- …highly motivated individual for the position of **Multi-Specialty Portfolio Specialist .** In this field-based role, the **Multi-Specialty Portfolio Specialist ... tactical, energetic and thrive in a nimble organization. The **Multi-Specialty Portfolio Specialist ** will demonstrate a sense of urgency to prepare and successfully… more
- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** Clinical Pharmacy Specialist **Cost Center:** 301641296 Pharmacy-Admin **Scheduled Weekly Hours:** 40 **Employee ... (United States of America) **Job Description:** **JOB SUMMARY** The Clinical Pharmacy Specialist works with physicians, staff, and committees to optimize the care of… more
- Prime Therapeutics (Madison, WI)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Molina Healthcare (Racine, WI)
- …claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims ... accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST will require to work 1… more
- Molina Healthcare (Kenosha, WI)
- …claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims ... accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for the comprehensive… 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
- 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
- SSM Health (Madison, WI)
- …provide medical equipment and supplies. + Verifies patient insurance eligibility /benefits and communicates financial responsibilities to patients, caregivers, and ... and prior authorization for appropriate equipment/supplies. + Ensures compliance with Medicare, Medicaid and Accreditation Standards. + Works in a constant state of… more
- CVS Health (Madison, WI)
- …and predetermination of covered benefits in the commercial, Medicare, and Medicaid environment. This Wheelchair DME consultant provides subject matter expertise in ... application of Aetna policies and practices for commercial, Medicare, and Medicaid environments. ◾Proactively use data analysis to identify opportunities for quality… more
- St Croix Hospice (Delavan, WI)
- …physical assessments, performs face to face assessments and evaluates hospice eligibility as assigned in consultation with the hospice interdisciplinary team. The ... prior to the third and subsequent hospice benefit periods to assess hospice eligibility based on the hospice conditions of participation and the local coverage… more