- Prime Therapeutics (Madison, WI)
- …identify compliance requirements, assess risks, and recommend compliant solutions that support enterprise goals + Conducts analysis to create written reports, ... Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible… more
- Molina Healthcare (Green Bay, WI)
- …Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing ... applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA...is easy to understand and provides insights needed to support strategic investment decisions + Research and develop reports… more
- Prime Therapeutics (Madison, WI)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance Marketplace business + Manage incoming requests for… more
- Humana (Madison, WI)
- …healthcare and/or health insurance industries + Healthcare research experience + Medicare /senior consumer experience **Additional Information** To ensure Home or ... its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage… more
- CVS Health (Madison, WI)
- …medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated ... the industry-leading clinical operations and population health platform to support the delivery of high quality care to the... the delivery of high quality care to the Medicare population. As a Senior Product Manager within the… more
- Evolent (Madison, WI)
- …to the Utilization Management process, interpretation, guidelines and/or system support . + Participates in on-going training per inter-rater reliability process. ... 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
- Robert Half Accountemps (Milwaukee, WI)
- …insurance payers to resolve outstanding issues. * Ensure compliance with Medicare , Medicaid, and other government insurance regulations. * Communicate effectively ... billing platforms. * Solid knowledge of insurance claims procedures, including Medicare and Medicaid. * Exceptional attention to detail and problem-solving skills.… more
- Aveanna Healthcare (Appleton, WI)
- …Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance + Robust ... the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- 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 ... ensure timely and accurate member support . + Maintain accurate records and documentation while meeting productivity and quality standards. **Candidates for Billing… more
- Aveanna Healthcare (La Crosse, WI)
- …relations, and efficiency of service within the team. Act as a resource and support for clinical staff and facilitate collaborative teamwork on the unit and with ... of the application + Bachelor's degree required Preferred: + Medicare skilled nursing experience + Basic understanding of OASIS...in health care (home health) As an employer accepting Medicare and Medicaid funds, employees must comply with all… more