- 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. ... reporting on progress, challenges, and achievements to management. + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs… more
- Cognizant (Madison, WI)
- …Director based on the review of clinical documentation in accordance with Medicare , Medicaid , and third-party guidelines. . Effectively document and log ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… 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. ... reviewing criteria to ensure appropriateness of care preferred + Previous Medicare experience a plus + Milliman MCG experience preferred **Additional Information**… 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. ... Certified Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique education… 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. ... + 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… 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. ... 2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability +… more
- Evolent (Madison, WI)
- …under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . . No history of disciplinary or legal action by a state medical… 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. ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage experience + Strong Communication Skills + Ability to… more
- Evolent (Madison, WI)
- …under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… 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. ... improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage experience Travel: While this is a remote position,… more