- CVS Health (Chicago, IL)
- …each and every day. **Position Summary** + Provide actuarial support for the Medicaid Revenue Integrity projects by + Continue to improve the process for reporting ... in Excel, some programming experience **Preferred Qualifications** + Experience in Medicaid + Experience with SQL **Education** + Bachelor's degree in Actuarial… more
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. **Position Summary** Support the Medicaid Pharmacy team, including forecasting, reporting and pharmacy analytics across all ... Medicaid states. Perform actuarial functions by applying expanded quantitative...all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- Centene Corporation (Jefferson City, MO)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... benefits including a fresh perspective on workplace flexibility. **Nebraska Medicaid ** **Must have NE license or Compact RN license** **Does not require NE… more
- WellSense (Nashville, TN)
- …across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, ... that fosters trust, builds loyalty, and contributes to member retention. . **Call Management :** Respond to a high volume of inbound calls from members and providers,… more
- Trinity Health (Ann Arbor, MI)
- …of Medicaid and other financial assistance application and initiates eligibility determination for Health System's charity care fund. Follows up on delinquent ... payments. Assists potentially eligible patients in completing forms for bank loans, Medicaid , CMHS charity care and other sources of financial assistance within… more
- State of Montana (Helena, MT)
- …for identifying and investigating potential fraud, waste, and abuse within Montana Medicaid and Healthy Montana Kids (HMK) programs. Key duties include analyzing ... retirement plans, paid vacation, sick leave, and holidays, work/life balance, and eligibility to participate in the Public Service Loan Forgiveness (PSLF) program.… more
- Cognizant (Blaine, MN)
- …enhance our healthcare claims processing systems. With a focus on Medicare and Medicaid claims you will leverage your expertise in OnBase Application Enabler Work ... systems and enhance data exchange capabilities. - Oversee the creation and management of OnBase workflows to automate claims processing tasks. - Ensure compliance… more
- CareFirst (Baltimore, MD)
- …supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid , and ACA markets. This role ensures operational compliance by supervising ... and adherence to regulatory requirements. Provide coaching, mentorship and performance management to meet productivity targets and regulatory deadlines. Assign and… more
- CVS Health (Charleston, WV)
- …schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases for clinical and legal ... year, depending on business needs) **Preferred Qualifications** + Previous Medicaid /Medicare investigatory experience + Exercises independent judgement and uses… more
- Penn Medicine (Plainsboro, NJ)
- …X-rays. Validation includes but is not limited to verifying eligibility , obtaining benefits, ensuring pre-certification and/or authorization /referral requirements ... to have been completed. Refers patient to Medicaid Screener or Financial Counselor as needed. + Demonstrates...Media Manager. + Processes correspondence from insurance carriers, case management and other areas within one business day of… more