- National Health Care Associates (Stafford Springs, CT)
- …personalized resident care plans and the capture of clinical reimbursement for services provided. You will ensure the highest level of revenue integrity and ... federal regulations for MDS completion and coding conventions. **Key Responsibilities:** + Lead and oversee the MDS program, ensuring compliance and accuracy in… more
- National Health Care Associates (Valley Stream, NY)
- …in accordance with GAAP standards + Conduct variance analysis and provide insightful recommendations to improve financial performance and operational efficiency + ... Lead the annual budgeting process and collaborate with departmental...with regulatory requirements and internal policies, including Medicare and Medicaid billing regulations + Assist in special projects and… more
- Humana (Madison, WI)
- …and serving as the primary financial liaison to the Wisconsin Medicaid agency. **Key Responsibilities** ** Provide market-specific financial leadership, ... WI market trend initiatives for all products within WI Medicaid ** ** Lead financial analytics, scenario planning, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Indianapolis, IN)
- …for the overall strategic direction, oversight, and administration of programs and services for our Medicaid program. Humana Healthy Horizons in Indiana ... market includes both Waiver programs, which provide long-term services and support to eligible...which serve members who qualify for both Medicare and Medicaid . They will lead the state … more
- Louisiana Department of State Civil Service (Lake Charles, LA)
- …seeking a motivated Medicaid Analyst Supervisorto lead a team of Medicaid Analysts and ensure high-quality, accurate service delivery. In this role, you ... and federal policies, support staff with complex cases, monitor case quality, provide in- service training, and handle reviews, investigations, and fair-hearing… more
- Humana (Honolulu, HI)
- …understanding of healthcare operations, particularly around claims processing, enrollment, provider data management and clinical operations; Medicaid preferred ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Indianapolis, IN)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical Director ... members in the KY, OH, VA, WI and IN Medicaid market populations. May provide cross-coverage for...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Medicaid Provider Audits and Investigations Manager** **Job Class: Human Services Manager 2** **Agency: Human Services Dept** + **Job ... with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : Yes The Department of Human Services (DHS) is unable to provide sponsorship… more
- CVS Health (Chicago, IL)
- …from Providers, such as HEDIS, Revalidation, Grievance and Appeals, SIU, etc. Coordinate provider status information with Member/ Provider Services and other ... + Data & Insights Utilization: Leverage analytics to identify trends, address escalated provider concerns, and enhance service delivery. Assist PE staff to… more
- DATAMAXIS (Springfield, IL)
- …Reporting, quality measures, claims processing, Medicaid program eligibility, provider enrollment, third-party liability. * Understanding of fee-for- service , ... Primary Responsibilities: * Provide direction, guidance and recommendations supporting decision making...and operations. * With the specialized knowledge of the Medicaid and Children's Health Insurance Programs, lead … more
