- Humana (Ashland, WI)
- …track quarterly face-to-face visits and monthly phone contacts. + Participate in the development and ongoing review and coordination of the member's plan of care. + ... Take the lead in areas related to social, community integration, employment,...consumer experiences **Preferred Qualifications** **Prior experience with Medicare & Medicaid recipients** + Previous experience with electronic case note… more
- Staffing Solutions Organization (Albany, NY)
- …drive actionable insights and improve healthcare analytics, with a focus on Medicaid -related data. This role requires expertise in AI/ML architecture, AI governance, ... technical teams to identify AI-driven opportunities, develop AI roadmaps, and lead the implementation of high-performance AI models. **Additional Requirements and/or… more
- Trinity Health (Columbus, OH)
- …ICD-9 coding to ensure compliance with third party regulations. Understands Medicare, Medicaid and other third party information requirements and adheres to all ... when registering patients + Using EPIC + Demonstrates understanding of Medicare, Medicaid and other third party information requirements and adheres to all third… more
- Atlantic Health System (Morristown, NJ)
- …oversee physician, real estate and contract management process, including development of electronic databases. Assume primary responsibility for physician contract ... fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid compliance, licensure issues, pay-to-play issues, corporate governance and regulatory… more
- Prime Therapeutics (Raleigh, NC)
- …on trend, benefit design and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid ). This role will also provide actuarial ... support, and maintain financial and complex actuarial models + Lead , perform, and review data analyses, reporting, and projections...or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 3 years of experience… more
- CenterWell (Houston, TX)
- …food insecurity, navigation of and application for benefits including, Medicaid , HCBS, working to reduce costs associated with prescription medications, ... organizing schedules of follow up appointments, alleviating social isolation + Lead Interdisciplinary Team Meetings when indicated + Assess patient's family system,… more
- Elevance Health (Richmond, VA)
- …supports work-life integration, and ensures essential face-to-face onboarding and skill development . Please note that per our policy on hybrid/virtual work, ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Medical...vary depending on the above factors as well as market/ business considerations. No amount is considered to be wages… more
- Dignity Health (Bakersfield, CA)
- …will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care ... This position is remote, but will be expected to work PST business hours.** **Position Summary:** The Manager, Network Strategy and Contracting reports to… more
- CVS Health (Richmond, VA)
- …call holiday weekend coverage required.** **The BH Clinical Liaison** is a clinical leader in the Medicaid plan focusing on utilization management, integrating ... member care, clinical coordination, leading the development , implementation and ongoing monitoring of program and quality initiatives to address the needs of Aetna… more
- Omaha Children's Hospital (Omaha, NE)
- …it matters most. **A Brief Overview** This position will serve as the leader and advocate for coordinating assigned functions for their teams to accomplish ... changes related to the department. + May participate in the implementation of business plans for the area. Responsible for the implementation and execution of … more