- Molina Healthcare (Green Bay, WI)
- …Analysis Professional (CBAP), or Certified Coding Specialist (CCS) certification. + Project Management Experience. + Familiarity with Medicaid -specific Scorable ... goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits &… more
- Molina Healthcare (Milwaukee, WI)
- …Analysis Professional (CBAP), or Certified Coding Specialist (CCS) certification. + Project Management Experience. + Familiarity with Medicaid -specific Scorable ... **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable… more
- Molina Healthcare (Madison, WI)
- …of experience in Healthcare (payer experience), Vendor Management, Data Analytics, Contract Terms and Conditions, Procurement, Project Management, or Account ... with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional… more
- Molina Healthcare (Milwaukee, WI)
- …and processing. This role will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and ... adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either… more
- Molina Healthcare (Kenosha, WI)
- …Analysis Professional (CBAP), or Certified Coding Specialist (CCS) certification. + Project Management Experience + Familiarity with Medicaid -specific Scorable ... Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits,… more
- Humana (Madison, WI)
- …campus and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network infrastructure environment ... to service level agreements, and ensuring all support and maintenance contracts and services are up-to-date and providing appropriate coverage. + Obsolescence… more