- CVS Health (Madison, WI)
- …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...Work defined campaigns that are designed to assist Aetna Medicare members holistically find the appropriate Aetna Medicare… more
- Molina Healthcare (Kenosha, WI)
- …Summary** Responsible for leading, organizing and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with ... the standards and requirements established by the Centers for Medicare and Medicaid. **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of… more
- Humana (Madison, WI)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
- Humana (Madison, WI)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an… more
- Humana (Milwaukee, WI)
- …our caring community and help us put health first** Are you passionate about the Medicare population, looking for an opportunity to work in sales with the ability to ... community events, as well as, visiting prospects in their homes. Our ** Medicare Sales Field Agents** sell individual health plan products and educate beneficiaries… more
- Molina Healthcare (WI)
- …PST hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing and resolving ... with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research… more
- Molina Healthcare (Green Bay, WI)
- …Affairs to assess and provide analyses for proposed changes to Medicare , and other government-sponsored healthcare program contracts, governing regulations and new ... 10 years' experience in Managed Care, specifically government programs and/or Medicare /Duals Health Plan Operations or equivalent combination of education and… more
- Humana (Madison, WI)
- …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Madison, WI)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... the Service Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including… more
- Molina Healthcare (Milwaukee, WI)
- …related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM ... portal, SLA tracking, and program audits. * Deep knowledge of Medicare regulations affecting complaints, grievances, and member communications. * Exposure to… more