• Payment Integrity Program Manager - Health Plan

    Molina Healthcare (Green Bay, WI)
    …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially… more
    Molina Healthcare (08/14/25)
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  • Audit & Reimbursement III (US)

    Elevance Health (Waukesha, WI)
    …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an… more
    Elevance Health (08/14/25)
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  • Hospital Concurrent Coding Specialist

    Intermountain Health (Madison, WI)
    …with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US ... skills. AND Demonstrated knowledge of government benefits and regulations related to Medicare , Medicaid or the ACA. AND Demonstrated knowledge of queries. _Preferred… more
    Intermountain Health (08/08/25)
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  • Sr Dir Pharmacy Trade Relations - Remote

    Prime Therapeutics (Madison, WI)
    …related partner/customer relationships including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid. The Sr Director, Pharm ... + Direct the oversight of Trade formulary strategies for Commercial, Exchange, Medicare Part D and/or Medicaid template formularies, including items such as… more
    Prime Therapeutics (08/08/25)
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  • Senior Systems Engineer - IAM

    Ensono (Madison, WI)
    …US Citizenship and pass related background checks including but not limited to Medicare and Medicaid and VA **Preferred Skills:** + Experience with secure file ... experience and a strong background in implementing and maintaining Centers for Medicare & Medicaid Services (CMS) security standards and compliance requirements. +… more
    Ensono (08/07/25)
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  • Manager, Enrollment - REMOTE

    Molina Healthcare (Green Bay, WI)
    …needed + Primary point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations. Coordinates and facilitates meetings ... Experience** 5-7 years Enrollment-related experience in Managed care or Medicare setting **Preferred Education** Graduate Degree or equivalent combination of… more
    Molina Healthcare (08/01/25)
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  • Regional VP, Health Services Central Region

    Humana (Madison, WI)
    …interrelate across segments and/or enterprise-wide. **Regional VP of Health Services, Humana Medicare Advantage** As the Regional VP of Health Services, you will ... and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider… more
    Humana (08/01/25)
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  • Plan President - Wisconsin

    Molina Healthcare (Green Bay, WI)
    …to families and individuals who qualify for government-sponsored programs, including Medicaid, Medicare , Managed Long-Term Services and Support (MLTSS) and - in some ... years of management experience. + Working knowledge of Medicaid and Medicare products. **Preferred Education:** + Master's Degree in Business, Health Administration,… more
    Molina Healthcare (07/25/25)
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  • Patient Assistance Counselor

    Marshfield Clinic (Weston, WI)
    …months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training ... time of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services at time of hire. **Marshfield Clinic Health System… more
    Marshfield Clinic (07/24/25)
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  • Payment Integrity Subrogation Manager - REMOTE

    Molina Healthcare (Milwaukee, WI)
    …for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and Marketplace lines of business. This includes direct management of ... to support efficient and compliant subrogation operations across Medicaid, Medicare , and Marketplace populations. + Collaborate with legal, claims, provider… more
    Molina Healthcare (07/23/25)
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