• Manager, Fraud and Waste * Special Investigations…

    Humana (Frankfort, KY)
    …continuously improving consumer experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD, ... match + Generous Paid Time Off accrual + Tuition Reimbursement + Parental Leave **WAH requirements** : * Must...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (09/05/25)
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  • Manager, Medical Economics ( Medicaid )…

    Molina Healthcare (Louisville, KY)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... Experience** + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with… more
    Molina Healthcare (08/27/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Louisville, KY)
    …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit ... and Reimbursement Senior** will support our Medicare Administrative...Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of… more
    Elevance Health (08/26/25)
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  • Audit & Reimbursement II (US)

    Elevance Health (Louisville, KY)
    …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit ... and Reimbursement II** will support our Medicare Administrative...Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of… more
    Elevance Health (09/06/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Frankfort, KY)
    …gain share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid , ACA, and commercial populations with the goal of ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population… more
    Highmark Health (08/20/25)
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  • Bilingual Reimbursement Specialist

    Cardinal Health (Frankfort, KY)
    …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, ... preferred + Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and… more
    Cardinal Health (09/03/25)
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  • Reimbursement Coordinator (Patient…

    Cardinal Health (Frankfort, KY)
    …a lot of different hats, without getting overwhelmed), required * Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers' policies and guidelines ... for coverage, preferred * Knowledge of DME, MAC practices, preferred * Prior understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred * Intermediate to advanced computer skills and proficiency in Microsoft Office including… more
    Cardinal Health (09/03/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Lexington, KY)
    …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... a Managed Care Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and… more
    Molina Healthcare (09/07/25)
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  • Special Project Business Office Manager - Long…

    Signature Healthcare (KY)
    …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified ... the REBOC and Controller and requirements set forth by Medicaid and Medicare . How you Will make...Plan + 401(K) and Roth 401(K) + Tuition Forgiveness/Education Reimbursement + A variety of additional specialized Insurances +… more
    Signature Healthcare (08/08/25)
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  • Senior Analyst, Medical Economics (Vbc) - Remote

    Molina Healthcare (KY)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... + 5+ years of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work… more
    Molina Healthcare (08/31/25)
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