- Actalent (Tempe, AZ)
- …training, or an equivalent combination of education and experience. + Knowledge of Medicaid . + Experience in Pharmacy Benefits Management (PBM) is preferred. + ... Skills & Qualifications + Experience with MTM, Medicare, Retail pharmacy, Medicaid , Insurance verification, and Pharmacy benefits management . + Proficient… more
- National Health Care Associates (Ridgefield, CT)
- …Center in Ridgefield. Applicants must be experienced in skilled nursing business office management including: + Medicaid , Medicare and Managed Care Billing + ... Revenue Cycle Management in the areas of census, ancillaries, billing, adjustments,... or supervisory responsibilities + Thorough knowledge of Medicare, Medicaid , Pending, Applied Income, and Managed Care reimbursement regulations… more
- CVS Health (Hartford, CT)
- …director to be part of a centralized team that supports the Medical Management staff ensuring timely and consistent responses to members and providers related to ... be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and...+ years of experience in managed care (Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS… more
- CVS Health (Phoenix, AZ)
- …care they need. **Required Qualifications** **Knowledge of:** + 3+ years of Pharmacy Benefit Management , Medicare Part D or Medicaid experience + 2 + years of ... analytical, and business support for all assigned programs for Medicare, Medicaid , and Commercial products. Programs currently include End-Stage Renal Disease… more
- CVS Health (Boston, MA)
- …within Network; Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across ... alignment across the broader platform strategies and capabilities. + Provide change management rigor to ensure smooth transitions for end users while implementing… more
- Adams County Government (Westminster, CO)
- …Program (SNAP), Colorado Works (TANF), and Adult Financial Programs. + Process eligibility documentation and provide ongoing case management and follow-up ... Looks Like In This Job This position guides customers through the eligibility process for the anti-poverty programs offered through Adams County including Health… more
- The Children's Village (Dobbs Ferry, NY)
- Position Overview: Reporting to the Care Management Supervisor, the Care Manager will identify and outreach potentially eligible clients, engage the families or ... and enroll the client in the Health Home Care Management program. Once clients are enrolled the Care Manager...Ongoing coordination also includes quarterly review of the child's eligibility and completing a care plan review and an… more
- TEKsystems (Morrisville, NC)
- …and navigate major payer types, including private/commercial and government (Medicare, Medicaid , VA, DOD). + Maintain accurate records in compliance with program ... complex cases appropriately and follow program guidelines. + Collaborate with Program Management , Franchise Managers, and Clients to share insights and feedback. +… more
- Centene Corporation (Harrisburg, PA)
- …a subsidiary of Centene Corporation and will oversee program initiatives for the Medicaid product line of business encompassing HEDIS, and CAHPS by utilizing cross ... process documentation including meeting minutes, action items, issues lists and risk management plans as applicable. + Create and monitor all department deliverables… more
- CVS Health (Scottsdale, AZ)
- …Director, Software Development Engineering** provides leadership and direction to the Medicaid Member & Enrollment Domain; oversees and directs the various teams ... that support Member services and the Enrollment departments across Medicaid . Create best-in-class solutions that integrate technology, information and business… more