• Clinical Reviewer, Nurse

    Evolent (Madison, WI)
    …and a great place to work? Definitely. Evolent Health International (Pune, India) has been certified as "Great Places to Work" in 2021. In 2020 and 2021 Evolent in ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of disciplinary or legal action… more
    Evolent (08/19/25)
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  • RN Care Manager Remote with field travel in WA…

    Molina Healthcare (Racine, WI)
    …and the site of service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous Case Management experience and ... proficient knowledge of MS Suite, organized and analytical thinking. Experience with Medicare /Medicaid, MS 365 and familiarity with claims is highly preferred. The… more
    Molina Healthcare (08/08/25)
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  • Claims Examiner, Liability

    Sedgwick (Wausau, WI)
    …achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in ... limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
    Sedgwick (08/08/25)
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  • Home Health LPN Clinical Coordinator Full Time

    Aveanna Healthcare (Brookfield, WI)
    …reimbursement What You Bring + Active LPN license (state-specific) + CPR certified + Valid driver's license, insurance, reliable transport, clean driving record + ... Points + Experience in home care + Knowledge of Medicare and accreditation standards + EMR savvy (HCHB preferred)...Willing to travel as needed As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (07/29/25)
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  • Field Care Manager, Ltss (RN)

    Molina Healthcare (WI)
    …Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside in Bexar ... will be given to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as… more
    Molina Healthcare (07/20/25)
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  • Specialist, Corporate Credentialing

    Molina Healthcare (Milwaukee, WI)
    …if providers have sanctions/exclusions. * Reviews and processes monthly daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes assigned daily NPDB Continuous...School Diploma or GED **Required Experience/Knowledge Skills & Abilities:** Certified Provider Credentialing Specialist (CPCS) or participation in a… more
    Molina Healthcare (07/19/25)
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  • Emergency Medical Technician - Basic / Advanced…

    Marshfield Clinic (Rice Lake, WI)
    …emergency functions. This individual functions independently while applying the skills of the certified EMT in an ambulance setting. The Critical care level based on ... acceptable to MCHS's insurer. + Emergency Vehicle Operations Certification (EVOC), Certified Emergency Vehicle Operator (CEVO), or Emergency Vehicle Driver Training… more
    Marshfield Clinic (08/19/25)
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  • Director of DevSecOps Automation and Engineering

    Humana (Madison, WI)
    …NIST, BSIMM. * Professional security management certification, such as a Certified Information Systems Security Professional * (CISSP), Certified 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 (08/15/25)
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  • Health Unit Coordinator/Emergency…

    Marshfield Clinic (Marshfield, WI)
    …and Accreditation._ **Minimum Required:** Must have or has had a Certified Nursing Assistant (CNA) certification, or Emergency Medical technician (EMT) awarded ... of Wisconsin, or Health Unit Coordinator (HUC) program. **Preferred/Optional:** Certified nursing assistant (CNA) experience. **EXPERIENCE** **Minimum Required:** None… more
    Marshfield Clinic (08/15/25)
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  • Sr. Compliance Analyst - Remote

    Prime Therapeutics (Madison, WI)
    …or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible ... applications for licensure **Preferred Qualifications** + PBM/health care experience + Certified Compliance and Ethics Professional (CCEP) or Certified more
    Prime Therapeutics (08/14/25)
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