- Novo Nordisk (Wausau, WI)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Coverage Gap, Copays, and Deductibles and the impact on customer decisions + Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify business… more
- SSM Health (Madison, WI)
- …Facilitates compliance with The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS) and state quality and patient safety requirements by ... coordinating, organizing and communicating appropriate information to designated committees, teams, work groups and leadership in a timely fashion. Leads initiatives for high priority opportunities as identified by leadership. + Performs other duties as… more
- SSM Health (Madison, WI)
- …and prior authorization for appropriate equipment/supplies. + Ensures compliance with Medicare, Medicaid and Accreditation Standards. + Works in a constant state of ... alertness and safe manner. + Performs other duties as assigned. EDUCATION + High School diploma/GED or 10 years of work experience EXPERIENCE + Two years' experience PHYSICAL REQUIREMENTS + Frequent lifting/carrying and pushing/pulling objects weighing 0-25… more
- Molina Healthcare (Madison, WI)
- …with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid , National Committee for Quality Assurance… 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
- Molina Healthcare (Green Bay, WI)
- …(HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically appropriate clinical ... guidelines, Medicaid , Medicare, CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access and interpret these guidelines. *… more
- Marshfield Clinic (Eau Claire, WI)
- …(AMI), Certified Biomedical Electronics Technician (CBET), Certified Radiology Equipment Specialist (CRES), or Certified Laboratory Equipment Specialist (CLES) ... excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify… more
- Banner Health (WI)
- …with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Certified… more
- Marshfield Clinic (Eau Claire, WI)
- …provided by the American Heart Association. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES) ... excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify… more
- Marshfield Clinic (Marshfield, WI)
- …provided by the American Heart Association. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES) ... excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify… more