- City of New York (New York, NY)
- …staying abreast of the Department of Health (DOH) policy changes to ensure that Medicaid eligibility factors are correctly stated, using plain language text so ... external oversight requirements before drafts are submitted to the Director and management for secondary review and approval. Make necessary corrections to both… more
- UTMB Health (Galveston, TX)
- …+ Build Hospital Account Record (HAR) for every follow up appointment, checking Medicaid eligibility and insurance status. + Check clinic records to update ... (LVN) - Women's Health **Galveston, Texas, United States** Nursing & Care Management UTMB Health Requisition # 2405323 **Minimum Qualifications:** Graduation from a… more
- CVS Health (Winchester, KY)
- …Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid and face a variety of complex health and social challenges. Through compassionate ... locations, medical facilities, and other locations. + Completing care management focused assessments. + Setting member-centered goals. + Identifying barriers… more
- CVS Health (Columbia, SC)
- …+ Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + Familiarity with community ... home healthcare coordination experience **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members. + Experience… more
- CVS Health (Albany, NY)
- …* Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. * Familiarity with community ... home healthcare coordination experience **Preferred Qualifications** * Experience providing care management for Medicare and/or Medicaid members. * Experience… more
- CVS Health (Blue Bell, PA)
- …the operational and financial performance evaluation across Aetna's Commercial and Medicaid Care Management programs to optimize the programs' performance, ... for building and maintaining staffing models that support the Commercial and Medicaid Care Management programs. Key responsibilities of this role include:… more
- CareFirst (Baltimore, MD)
- …and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Leadership - Medicaid & Medical ... overall product success. **ESSENTIAL FUNCTIONS:** + Leads the entire product management life cycle -Translates business strategy are reflected in downstream product… more
- CVS Health (Helena, MT)
- …to join it's CVS Health's leadership team as a Director, Pharmacy Benefit Management (PBM) Underwriting, Analysis and Strategy. In this role, you will lead a ... and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid , Medicare Part D, and Public Exchange lines of business. + Conduct… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - ... outreach and community events. Essential Accountabilities: Level I * Educates Medicaid , Medicare, and Commercial members on healthcare benefits, and community… more
- CVS Health (Springfield, IL)
- …PBM. In this role you may provide consultative clinical support to Account Management in support of Key Clients as assigned. The Medical Director transacts ... Utilization Management UM activities (prior authorization and appeals) and responds to prescriber inquiries related to UM transactions and more generally related to… more