• Memory Care Case Manager

    Bluestone Physician Services (Franklin, WI)
    medicare -26-6-million/) as measured by the overall savings per Medicare beneficiary. Position Overview: The Memory-Care Case Manager ... Managers and other medical professionals. The Behavioral Health Care Manager is a patient-focused role, primarily working with a...on Fridays. Location: This position entails a mix of remote work, as well as primarily direct patient care… more
    Bluestone Physician Services (08/02/25)
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  • Utilization Management Nurse

    CenterWell (Madison, WI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing… more
    CenterWell (08/02/25)
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  • Senior Product Owner

    CenterWell (Madison, WI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to… more
    CenterWell (08/23/25)
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  • Complex Care Strategy Advancement Advisor

    CenterWell (Madison, WI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value...markets or team on-sites Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    CenterWell (07/19/25)
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  • Regulatory Specialist Senior

    SSM Health (Fond Du Lac, WI)
    …a working knowledge of all The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS) Conditions of Participation and State Hospital Licensing ... of continual readiness related to The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Conditions of Participations (CoPs) and State specific… more
    SSM Health (07/29/25)
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  • Clinical Documentation and Claims Integrity…

    Elevance Health (Waukesha, WI)
    …Alternate locations may be considered. This position will work a hybrid model ( remote and office). The ideal candidate will live within a commutable distance from ... end-to-end claims/ encounter processing, as well as ensuring compliance with Medicare / Medicaid regulatory policies regarding FFS and zero-dollar claims. **How you… more
    Elevance Health (08/14/25)
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  • EReferral Specialist Home Health Per Diem

    CenterWell (Madison, WI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... the delivery of home health services preferred + Working knowledge of Medicare enrollment and guidelines governing home health agencies preferred + Demonstrated… more
    CenterWell (08/26/25)
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  • Principal, Financial Planning & Analysis,…

    Humana (Madison, WI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits , and opportunities to grow yourself and your career. We proudly employ… more
    Humana (08/19/25)
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  • Senior Clinical Programs Pharmacist

    CenterWell (Madison, WI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... consumer experiences **Preferred Qualifications** + Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid… more
    CenterWell (08/08/25)
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  • Lead Cloud Network Engineer

    Humana (Madison, WI)
    …campus and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network infrastructure environment ... for future budget forecasting and planning needs. + Communicate status updates to Manager of IT and other Senior business leaders where necessary. + Research and… more
    Humana (08/20/25)
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