- Molina Healthcare (Kenosha, WI)
- **(Sales) Compliance Analyst** Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a ... Operating Procedures and Training documents. . Lead regularly scheduled Sales & Compliance leadership meetings. . Interpret and analyze Medicare , Medicaid, and… more
- Humana (Madison, WI)
- …requirements development. + Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance, and compliance + Determine ... community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Sedgwick (Sun Prairie, WI)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- Prime Therapeutics (Madison, WI)
- …every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government ... Programs - Medicare & Managed Medicaid is responsible for the development,...objectives are met and/or exceeded; instill a culture of compliance , accountability, and superior service within the Government Programs… more
- Humana (Milwaukee, WI)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Gentiva (Stevens Point, WI)
- …role is responsible for ensuring the appropriate delivery of hospice services, compliance with Medicare Hospice Benefit Conditions of Participation, state ... Maintain compliance with federal, state, and local regulations, including Medicare and state survey requirements + Participate in orientation, training, and… more
- CenterWell (Madison, WI)
- …or similar methodologies. ** Compliance & Risk Management** * Ensure compliance with Medicare , Medicaid, and commercial payer authorization and revalidation ... patient access. The Director partners closely with clinical leadership, operations, finance, compliance , and IT, and manages both onshore and offshore teams. The… more
- CVS Health (Madison, WI)
- …use, less expensive, and puts the consumer at the center of their care. Aetna's Medicare Stars Team is growing and expanding! This is exciting opportunity to join a ... role-based access control, masking, lineage, and metadata to support analytics and compliance . + Partner with product, ML/AI, BI, and engineering teams to translate… more
- CenterWell (Madison, WI)
- …to obtain details necessary for prioritization (eg member experience improvements, compliance impacts, client goals, etc.) + Create project intake and prioritization ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- Molina Healthcare (Milwaukee, WI)
- …to meet critical needs + Escalates gaps and barriers in implementation and compliance to AVP, VP and senior management + Consultative role, develops business case ... methodologies for programs, develops and coordinates implementation of business strategy + Collaborates and facilitates activities with other units at corporate and Molina Plans. **JOB QUALIFICATIONS** **Required Education** Bachelor's degree or equivalent… more