• Medical Director-Payment Integrity

    Humana (Carson City, NV)
    …conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid , and Medicare Advantage requirements and will understand how to ... of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/… more
    Humana (12/11/25)
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  • Information and Eligibility Specialist Brevard…

    Community Based Care of Brevard, Inc. (Rockledge, FL)
    …and processes client information to determine eligibility for Federal/State funding and Medicaid . In this role you will assist in resolving problems, locating ... Obtains and maintains appropriate eligibility documentation Completes applications for Medicaid and Federal/State Funds Maintains open communication with Protective… more
    Community Based Care of Brevard, Inc. (12/11/25)
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  • Facilitated Enroller (In Field - Brooklyn, NY)

    Molina Healthcare (Brooklyn, NY)
    …screens potentially eligible recipients for enrollment into Government Programs such as Medicaid / Medicaid Managed Care, Child Health Plus and Essential Plan. ... screen and assist potentially eligible recipients with the enrollment process into Medicaid / Medicaid Managed Care, Child Health Plus the Essential Plan and… more
    Molina Healthcare (12/11/25)
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  • Strategy Advancement Advisor - LTSS

    Humana (Indianapolis, IN)
    …​ **Required Qualifications** + Bachelor's degree or equivalent experience in Medicaid managed care + Excellent verbal and written communications + Strategic ... of success in driving operational improvement + Experience dealing with external Medicaid and Medicare regulatory agencies + Must be passionate about contributing to… more
    Humana (12/11/25)
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  • Addictions Counselor 2 (Kingsboro ATC)

    New York State Civil Service (Brooklyn, NY)
    …eligible and maintain eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and ... Medicaid /Medicare eligibility will result in the termination of employment.Mandatory...maintain eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification… more
    New York State Civil Service (12/11/25)
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  • Associate General Counsel Senior - Commercial…

    Elevance Health (San Juan, PR)
    …by law. MMM Holdings, LLC is a company that provides Medicare Advantage and Medicaid plans in Puerto Rico. Currently, MMM Holdings, LLC operates in Puerto Rico under ... negotiating vendor contracts, and leveraging in-depth knowledge of a Medicaid and Medicare specialty or area of law to...practice for a Varity of agreements including Medicare and Medicaid related vendor agreements. **How you will make an… more
    Elevance Health (12/11/25)
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  • Eligibility Specialist

    WelbeHealth (CA)
    …coverage. This role works directly with CMS, DHCS, and county Medicaid offices to troubleshoot eligibility issues, correct misalignments, and advocate for ... + Act as an organizational expert in Medicare or Medicaid eligibility policies and keep teams informed of regulatory...+ Minimum of three (3) years of experience in Medicaid , Medicare, or social services + Minimum of one… more
    WelbeHealth (12/11/25)
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  • QIDP Supervisor

    Daybreak Independent Services (Bronx, NY)
    …the delivery of high-quality, person-centered services that comply with OPWDD, Medicaid , and agency standards. This role supports our mission through leadership, ... and Staff Action Plans. * Oversee service delivery to ensure OPWDD and Medicaid compliance. * Conduct routine site visits and program reviews. Supervision &… more
    Daybreak Independent Services (12/10/25)
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  • Vendor Collections Management Specialist

    HCA Healthcare (Caldwell, ID)
    …and bankruptcy accounts from patients and/or vendors. + Assist with the Medicaid Eligibility vendor reconciliation, as requested. + Manages the onboarding and ... termination process for vendors + Provides support during vendor transitions: Medicaid Eligibility, Early Out, Primary and Secondary agencies. + Maintains all agency… more
    HCA Healthcare (12/10/25)
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  • Financial Management Advisor

    Insight Global (Indianapolis, IN)
    …include reviewing 6-8 cost reports prepared by team members, and handling Medicaid DSH Eligibility and HSL surveys. You will coordinate projects, analyze financial ... and Home Office, ensuring accuracy and compliance. Coordinate the completion of Medicaid DSH Eligibility and HSL surveys. Review and analyze financial data from… more
    Insight Global (12/09/25)
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