- Humana (Madison, WI)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness… more
- Humana (Madison, WI)
- …of established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Humana (Madison, WI)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via… more
- Molina Healthcare (WI)
- …documents. + Lead regularly scheduled business meetings. + Interpret and analyze Medicare and Medicaid communications. + Review and interpret internal dashboards ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a… more
- Molina Healthcare (Racine, WI)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks +… more
- Humana (Madison, WI)
- …responsible for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare , and DSNP states, while maintaining adherence to all ... Lead is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with… more
- Humana (Madison, WI)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Madison, WI)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Madison, WI)
- …hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid , or Commercial health insurance. +… more
- Humana (Madison, WI)
- …Provider Contracting, Provider Education and Provider Engagement in support of Humana's Group, Medicare , and Medicaid lines of business. This position reports to ... can be expected **Key Responsibilities** + Strategic Partner with all segments ( Medicare , Group and Medicaid ) accountable for developing and maintaining… more