- Person Centered Services (Rochester, NY)
- …utilizing the core standards of service. These include: + Comprehensive Care Management + Care Coordination and Health Promotion + Comprehensive Transitional Care + ... while tailoring services to individual needs. + Completes enrollment and eligibility documentation. + Completes and secures consents and authorizations to share… more
- Chiesi (Boston, MA)
- …years' experience in customer contracting and pricing required; with rebate management , contract analytics, chargebacks or a related pharmaceutical pricing and ... and strong understanding with government programs, such as the IRA, 340B, State Medicaid , and Medicare Part D. + Relevant experience with distribution networks, new… more
- CareFirst (Baltimore, MD)
- …geographically competitive, offers broad access, and meets cost and trend management objectives. **Regulatory and Healthcare Landscape** + Monitors and remains ... + Knowledge of healthcare or health insurance payor industry (Medicare, Medicaid , Commercial, DSNP and other payor programs), including legal and regulatory… more
- Elevance Health (St. Louis, MO)
- …trend analysis, financial reporting, financial operations, and cost and budget management and allocation. Responsible for reporting and delivery of key information ... to senior management to generate cost saving or revenue enhancement ideas...**Preferred Skills, Capabilities and Experiences:** + MBA preferred. + Medicaid Experience preferred. For candidates working in person or… more
- Centene Corporation (Sacramento, CA)
- …- 4 years of related experience. Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Molina Healthcare (Fort Worth, TX)
- …or Texas. This team reviews the prior authorization requests for our New Mexico Medicaid recipients. Preference will be given to those whose UM experience is within ... evidence based clinical guidelines. + Identifies appropriate benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization… more
- CVS Health (Hartford, CT)
- …expert to staff and customers for the pre-credentialing processes within the Medicaid credentialing team.. Sets and manages action plans for network initiatives, ... - Actively participates in team meetings. **Preferred Qualifications** - Strong desk management skills. - 3+ years of Credentialing experience - Knowledge of EPDB,… more
- Centene Corporation (Dover, DE)
- …and ongoing performance measures and recommend actions plans to senior management . + Research and incorporate quality improvement best practices into operations. ... to improve quality of care and service delivery, and knowledge of Medicaid . Experience managing acquisition and integration of external data sources. Previous … more
- University of Washington (Seattle, WA)
- **Job Description** **UW Medicine Insurance Eligibility and Financial Counseling Services Team (IECS)** has an outstanding opportunity for a **Financial Counselor ... Health Benefit Exchange and UW Medicine's Financial Assistance (Charity) and Medicaid application policies. + Prepare and present reports and documentation using… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- …and advocates and determines appropriate resolution; + Provides support to facility management activities; + In a designated regional operation ensures provision of ... laws, statutes and regulations; + Knowledge of + and ability to apply management principles and practices; + community organizations and social services agencies; +… more