• Home Health RN Assistant Clinical Manager

    Aveanna Healthcare (Waupaca, WI)
    …the state of the application * Associate's degree required * Valid CPR * Medicare skilled nursing experience preferred * Basic understanding of OASIS preferred * RN ... experience in health care (home health) preferred As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
    Aveanna Healthcare (11/25/25)
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  • Home Health Registered Nurse RN Full Time

    Aveanna Healthcare (Blair, WI)
    …in the state of application + Valid CPR and Drivers License Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year RN experience in ... a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions,… more
    Aveanna Healthcare (11/24/25)
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  • Home Health RN Clinical Manager

    Aveanna Healthcare (Brookfield, WI)
    …maintain active CPR per agency policy. Preferred: * Bachelor's degree preferred * Medicare Skilled Nursing experience and a basic understanding of OASIS * 3+ years ... in a healthcare setting (home health preferred) As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
    Aveanna Healthcare (11/24/25)
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  • Utilization Management Nurse

    Humana (Madison, WI)
    …reviewing criteria to ensure appropriateness of care preferred + Previous Medicare experience a plus + Milliman MCG experience preferred **Additional Information** ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/24/25)
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  • Technology Lead

    Humana (Madison, WI)
    …+ Accounting/Finance knowledge/experience + Advanced SQL or similar + Medicare /Medicaid experience + Data architecture/solution architecture experience + Project ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/24/25)
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  • Claim Examiner - Liability | Remote

    Sedgwick (Madison, WI)
    …limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Excellent oral… more
    Sedgwick (11/22/25)
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  • Associate Specialist, Appeals & Grievances

    Molina Healthcare (Kenosha, WI)
    …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... * Customer/provider experience in a managed care organization (Medicaid, Medicare , Marketplace and/or other government-sponsored program), or medical office/hospital… more
    Molina Healthcare (11/21/25)
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  • Manager, Medical Economics (New York Health Plan)

    Molina Healthcare (Milwaukee, WI)
    …performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** **Required ... - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks + Proficiency… more
    Molina Healthcare (11/21/25)
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  • Associate Director, HEDIS Operations…

    Humana (Madison, WI)
    …and oversee execution of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for this role will thrive ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/21/25)
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  • Financial Analyst Senior

    SSM Health (WI)
    …+ Provides all government reimbursement services as assigned, including preparation of Medicare & Medicaid Cost Reports, Tricare Cost Reports, Wage Index, and ... mix reviews as directed by CMS. + Keeps updated on changes in Medicare & Medicaid compliance requirements. Participates in available training, including webinars and… more
    SSM Health (11/21/25)
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