- Prime Therapeutics (Madison, WI)
- …compliance with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program . + Ensures compliance with each State ... and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position...and regulations as they pertain to rebate processing and Medicaid Drug Rebate Program . + Ability to… more
- Walworth County (Elkhorn, WI)
- …for the Comprehensive Community Services (CCS), Case Management (CM) and Wisconsin Medicaid Cost Reporting (WIMCR) program services that are consistent with ... HS/LHCC Manager - Administrative Services (HHS) Print (https://www.governmentjobs.com/careers/walworthco/jobs/newprint/5028505) Apply HS/LHCC Manager -… more
- Humana (Viroqua, WI)
- …seeking a RN Case Manager to serve members in the Wisconsin Family Care (FC) program . As an RN Case Manager , you will be responsible for partnering with your ... **Preferred Qualifications** + Bachelor degree in nursing. + One ( 1 )+ years of experience with Family Care target group:...**Driving** This role is part of Humana's driver safety program and therefore requires an individual to have a… more
- Marshfield Clinic (Wausau, WI)
- …any time have been or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is a condition of employment. ... the most exciting missions in the world!** **Job Title:** Operations Manager - East Market **Cost Center:** 301671005 WC-Administration **Scheduled Weekly Hours:**… more
- Humana (Baraboo, WI)
- …our caring community and help us put health first** Humana is seeking Case Manager , aka: Community Resource Coordinator (CRC), to join the Inclusa team to serve ... members in the Wisconsin Family Care (FC) program . In this role, you will be responsible for...in the Human Services or related field with one ( 1 ) year of experience working with at least one… more
- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** The Manager , Provider Engagement establishes strategies and operational directions for risk adjustment and quality improvement. ... performance goals and manages progress for key performance indicators. + Ensures each Tier 1 , Tier 2 and Tier 3 provider has quality & risk adjustment performance… more
- Humana (Madison, WI)
- …help us put health first** Humana's Marketing organization is seeking a Lead Product Manager who specializes in Next Best Action (NBA) Decision Engine to join the ... personalized, and empathetic health experiences. As the Lead Product Manager for the Next Best Action (NBA) Decision Engine...in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and… more
- Prime Therapeutics (Madison, WI)
- …passion and drives every decision we make. **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote in Georgia **Job Description** Innovative business ... with pharmacy department or designated customer contacts. + Directs operations account manager in resolving customer service issues and actions supportive of the… more
- CVS Health (Madison, WI)
- …it all with heart, each and every day. **Position Summary** The Senior Manager , Dental Business Consultant is an individual contributor role with the following ... Requirements** . 5+ years of provider contracting experience - 1 - 2 years dental vendor experience * Knowledge of...years dental vendor experience * Knowledge of Medicare and Medicaid programs and contracts. * Ability to travel nationally… more
- Elevance Health (Waukesha, WI)
- **Risk Adjustment Actuarial Business Analyst II** **On-Site Requirement: Hybrid 1 ;** **This role requires associates to be in-office 1 - 2 days per week,** ... performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of business. **How You Will Make an… more