• 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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  • Technology Solution Implementation Professional

    Humana (Madison, WI)
    …existing environment while minimizing disruption and mitigating risks + Experience with Medicare and/or Medicaid + Ability to coordinate with development and user ... 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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  • Senior Coding Educator

    Humana (Madison, WI)
    …Certified Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique education ... 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 (11/20/25)
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  • Senior Director, Strategy & Analysis, Contract…

    Otsuka America Pharmaceutical Inc. (Madison, WI)
    …contracting and in-depth understanding of GPO/PBM/National and Regional Health Plan business models, Medicare Part D, Medicare Part B, 340B, and the changing ... market landscape + In-depth knowledge of patient access, launch excellence, marketing and business processes + Strong government pricing knowledge and experience + Strong financial acumen, forecasting, and modeling abilities + Proven ability to navigate… more
    Otsuka America Pharmaceutical Inc. (11/20/25)
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  • Sr Clinical Consultant - Wheelchair DME

    CVS Health (Madison, WI)
    …pre-certification, and predetermination of covered benefits in the commercial, Medicare , and Medicaid environment. This Wheelchair DME consultant provides subject ... and correct application of Aetna policies and practices for commercial, Medicare , and Medicaid environments. ◾Proactively use data analysis to identify opportunities… more
    CVS Health (11/20/25)
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  • Actuarial Analyst

    Humana (Madison, WI)
    …+ SAS and/or Databricks experience + Programming experience in SQL and VBA + Medicare Part D knowledge Travel: While this is a remote position, occasional travel to ... 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 (11/19/25)
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  • Associate Actuary

    Humana (Madison, WI)
    …2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability + ... 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 (11/19/25)
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  • Regulatory Analyst Sr - Remote

    Prime Therapeutics (Madison, WI)
    …processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid, and Health Insurance Marketplace for the assigned department. ... interpret regulations into operational requirements **Preferred Qualifications** + 2 years Medicare Part D, Medicaid, and/or state or federal regulatory experience +… more
    Prime Therapeutics (11/19/25)
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