• Patient Safety Specialist

    SSM Health (Madison, WI)
    …appropriate. + Facilitates compliance with The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS) and state quality and patient safety ... requirements by coordinating, organizing and communicating appropriate information to designated committees, teams, work groups and leadership in a timely fashion. Leads initiatives for high priority opportunities as identified by leadership. + Performs other… more
    SSM Health (08/28/25)
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  • Patient Support Specialist

    Cardinal Health (Madison, WI)
    …+ Cell/Gene therapy and/or Oncology experience, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred ... + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred + Important to have a strong attention to detail **TRAINING AND WORK SCHEDULES:**… more
    Cardinal Health (08/19/25)
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  • Senior Specialist , Provider Network…

    Molina Healthcare (Madison, WI)
    …Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other ... provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation. + Develops and maintains documentation and guidelines for all… more
    Molina Healthcare (08/02/25)
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  • Delaware Valley ACO Fellowship

    Humana (Madison, WI)
    …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health… more
    Humana (07/30/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Kenosha, WI)
    …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience + Proven… more
    Molina Healthcare (08/20/25)
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  • CIRV Technologist -or- CIRV Radiology Technologist…

    Marshfield Clinic (Eau Claire, WI)
    …provided by the American Heart Association. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES) ... Heart Association within three months of hire. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES)… more
    Marshfield Clinic (08/13/25)
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  • Senior Coding Data Quality Auditor, Coding Quality…

    CVS Health (Madison, WI)
    …applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. + Experience with International Classification of Disease (ICD)… more
    CVS Health (08/24/25)
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  • Billing Representative

    Adecco US, Inc. (Wausau, WI)
    …returned mail, and death claims. + Provide accurate cost estimates and Medicare eligibility information. + Collaborate with team members and business partners to ... + Detail-oriented with strong organizational skills. Preferred Qualifications: + Medicare and billing experience. + Healthcare industry background. **What's in… more
    Adecco US, Inc. (08/23/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Milwaukee, WI)
    …and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially ... ability to synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and Marketplace lines of business. + PMP, Certified… more
    Molina Healthcare (08/14/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Madison, WI)
    …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... 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 a major disciplinary or… more
    Evolent (07/30/25)
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