• Recovery - Coordinator 2

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …new specifications to the recovery system. + May serve as backup to management (ie Medicaid Program Supervisor, Medicaid Program Manager 1B). + Other tasks ... send responses to escalated matters. + Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims. + Participates in… more
    Louisiana Department of State Civil Service (11/05/25)
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  • Clinical Manager Home Health

    Tufts Medicine (Lowell, MA)
    …and team meetings on a regularly scheduled basis according to the agency's standards. Case conferences with staff as needed to meet the needs of challenging clients. ... + Evaluate staff understanding of documentation and compliance with regulations ( Medicaid , Medicare, DPH, OSHA, JCAHO, State and Federal) with QA input.… more
    Tufts Medicine (12/26/25)
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  • Business Office Manager HCC

    PruittHealth (Blue Ridge, GA)
    …collects past due rents in a timely manner to include working with Medicaid case managers, residents, family members and/or responsible parties. Follow Frontier ... Management collection policy. 15. Maintains resident, employee and other business files. 16. Manages time clock records; enter time off data; review missed punches; conduct error review 2 times per week; communicate clock-in policies with employees and inform… more
    PruittHealth (12/25/25)
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  • Sr Growth & Community Engagement Spc, Albq

    Molina Healthcare (NM)
    …membership growth and retention for Molina Healthcare of New Mexico Medicaid . + Build and maintain relationships with community-based organizations and healthcare ... + Strong presentation skills and broad knowledge of Nevada Medicaid is helpful. **If you are passionate about community...model. May also serve as the Acting Supervisor or Manager for the team upon management request. + Responsible… more
    Molina Healthcare (12/28/25)
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  • Utilization Review Nurse Coordinator (40 Hour)

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    …utilization review and/or quality assurance programs; + Conduct various types of case reviews for quality and appropriate medical management, cost containment, peer ... evaluates and monitors documentation of all hospital disciplines when performing case reviews; + Attend professional workshops, seminars and in-service training; +… more
    State of Connecticut, Department of Administrative Services (12/17/25)
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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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  • Complex Care Coordinator

    State of Montana (Helena, MT)
    …and subsequently implementing a complex care program and serves as the lead case manager . The position will report directly to the executive Director, ... Human Services (DPHHS) has a career opportunity within the Medicaid Health and Resource Branch.* This position is responsible...Career Opportunity ** * Knowledge of the principles of case management. * Knowledge of the principles and importance… more
    State of Montana (12/11/25)
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  • Audit & Reimbursement III and Senior

    Elevance Health (Charleston, WV)
    …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
    Elevance Health (12/30/25)
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  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... to identify red flags/aberrant billing patterns. + Manages cases as assigned, prioritizing case load as appropriate. Maintains case logs, prepares records and… more
    Excellus BlueCross BlueShield (12/17/25)
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  • LTSS Coordinator - Nevada

    System One (Las Vegas, NV)
    …Functions: + Serve as point of contact with the Primary Care Manager , Medical Director, Provider, or other internal/external stakeholders. + Collaborate as part ... existing documents to include, but not limited to, assessments, treatment plans, case notes, referrals, and care team members, ensuring compliance with accreditation… more
    System One (12/26/25)
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