- Molina Healthcare (Kenosha, WI)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, including experience in… more
- WestCare Foundation (Milwaukee, WI)
- …+ Maintain proper balance regarding source of payment (fee for service, Medicaid , public, private, and third-party payers) + Responsible for educating clients on ... with coverage and escalates complicated issues to the billing manager and/or director. + Coordinate with the billing ...basis. + Assist all clients with application process for Medicaid by assisting with completion of the application, addressing… more
- Marshfield Clinic (Weston, WI)
- …+ Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training offered after ... + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services at time of hire. **Marshfield Clinic Health System is committed… 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** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Marshfield Clinic (Marshfield, WI)
- …clinics within the Health System. This individual will assist with Medicare and Medicaid Cost Report coordination, Wage Index, S10, DSH and other governmental audits ... excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify… more
- Molina Healthcare (WI)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...+ 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis,… more
- 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 ... to The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Conditions of Participations (CoPs) and State...Serves and Lead in the absence of the Regional Manager . + Performs other duties as assigned. EDUCATION +… more
- Evolent (Madison, WI)
- …to find the most valuable defects. The IQA reports to a associate director or a manager . One or many IQAs may be engaged in any testing effort **What You Will Be ... + Responsible to escalate risks and issues in coordination with the lead / manager for status reporting + Responsible to enforce department standards as directed by… more
- Kenosha Human Development Services (Kenosha, WI)
- …House Job Title: Residential Stabilization Worker Reports To: Kauffman House Program Manager Type of Position: Full-time Schedule: Tuesday - Saturday, 2pm-10pm Pay ... for each youth 5. Work cooperatively with other Stabilization Workers and Program Manager to maintain a budget and to provide accurate fiscal documentation 6. Manage… more
- Elevance Health (Waukesha, WI)
- …and AI solutions that uncover early signals in cost trends across Medicaid , Medicare, Local Group, and Individual markets. You'll collaborate with actuaries, finance ... business problems under the direction of team lead or manager . + Work with data-sets of moderate size and...publish results under the direction of team lead or manager . + Support the evolution of early-warning systems and… more