- CVS Health (Nashville, TN)
- …initiatives to support audit readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure ... or compliance. + A minimum of 2 years of experience in provider data management and contracting support. + A minimum of 3 years managing, mentoring and growing… more
- CVS Health (Olympia, WA)
- …for high volume inbound provider calls for the Claims Inquiry/Claims Research Medicaid team. Extensive claims research on multiple platforms to assist providers with ... Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. + Work… more
- CVS Health (Harrisburg, PA)
- …together. - Acts as liaison between staff and other areas, including management , all segments, provider teams, etc., communicating workflow results, ideas, and ... - 2 years leading member/customer service team. - Experience in a Medicaid and/or Medicare setting. - Bachelor's Degree **Education** High School Diploma or… more
- CVS Health (Tallahassee, FL)
- …or Jacksonville **.** **Preferred Qualifications** -1-2 years of Healthcare or Medicaid experience -Trauma informed care training -Bilingual candidates preferred but ... not required -Exposure to Care Management -Experience in a production environment -Familiarity with de-escalations -Telework experience **Education** -High School… more
- TEKsystems (Montgomery, AL)
- …stored procedures, scalar/table-valued functions, and views. Proficient in SQL Server Management Studio (SSMS) and working in live production environments. Triage ... in a practical manner. Experience Preferred: Experience with State Government, Medicaid , CHIP and DHR business area or healthcare industry Education Required:… more
- CVS Health (Oklahoma City, OK)
- …you will: * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical ... necessity decisions * Provide comprehensive behavioral health care management to facilitate delivery of appropriate quality care and improve program/operational… more
- TEKsystems (Montgomery, AL)
- …Preferred: * Dashboard and report development visualization skills. * Content management application development skills. * Working with AI. Experience Required: A ... Pay and Benefits The pay range for this position is $50.00 - $55.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and… more
- Centene Corporation (Jefferson City, MO)
- …in progress and closed issues as well as regulatory sanctions. + Supports management in the development and maintenance of corrections processes and tools designed ... also include additional forms of incentives. Benefits may be subject to program eligibility . Centene is an equal opportunity employer that is committed to diversity,… more
- Communities Connected for Kids (Port Saint Lucie, FL)
- …new Adoption Title IV-E applications for children in Adoption placement. Assists case management in obtaining or completing eligibility documentation when a case ... that enters Out of Home Care. Enrolls each new Medicaid enrollee in the Sunshine Child Welfare Specialty Plan....on income, household composition and family resources to determine eligibility . Provides case management and private investigators… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …experience in lieu of degree. + 2 years of professional experience determining Medicaid eligibility . + Current working knowledge of the LaMEDS system. + ... Excellent analytical skills, effective organizational and time management skills. + Great attention to detail and follow...+ Minimum 4 years of professional experience in determining Medicaid eligibility . + Minimum 2 years of… more