- Centene Corporation (Columbus, OH)
- …of members, and aligns with the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid , the VP will also collaborate ... and aligns with Centene and the Ohio Department of Medicaid . + Lead population health initiatives with a strong...pay, health insurance, 401K and stock purchase plans, tuition reimbursement , paid time off plus holidays, and a flexible… more
- Deschutes County (Bend, OR)
- …excluded (or Opt-out) from participation in the federal health care programs ( Medicaid , Medicare and other federally funded programs that provide health benefits); ... services must be eligible to be enrolled in Oregon Medicaid as a MH Provider within the first 30...with federal regulations and is a prerequisite for receiving reimbursement for services provided to OHP members. All clinicians… more
- Teresian House (Albany, NY)
- …billing of all services rendered to residents in compliance with NYS Medicaid , Medicare, Mafae Care Organizations (MCO's) and private insurance. + Preparing and ... and working with families and third-party payers to ensure proper reimbursement . + Verifying resident insurance eligibility and insurance coverage using Availity,… more
- City of New York (New York, NY)
- …- Design, test, and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner, with 100% accuracy and timeliness, saving the ... program eligibility. Additionally, designing and operating analytics processes to identify Medicaid savings, both within DSS and State Department of Health (SDOH),… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the BCBS Association ... Maintains accurate and up-to-date knowledge of all Government Programs regulations ( Medicaid , Medicare, Federal Employee Program, New York State Department of… more
- Tufts Medicine (Melrose, MA)
- …program. + Works with hospice intake and eligibility department to verify insurance reimbursement for each referred patient and document in EMR. + Reviews and ... and financial obligations, using knowledge of hospice fees, costs and reimbursement sources. Escalates to referral management director and/or referral manager, in… more
- WMCHealth (Valhalla, NY)
- …payment of their medical treatment and to determine the method of payment/ reimbursement to Westchester Medical Center. This involves coordination with other Medical ... Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for coverage, the portion of… more
- CVS Health (Frankfort, KY)
- …guidance to the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director reports to the Senior Lead Pharmacy Director ... and operational aspects of pharmacy and prescription drug services within the Kentucky Medicaid health plan and to execute the Pharmacy Benefit in accordance with… more
- Ellis Medicine (Clifton Park, NY)
- …agencies, Medicare and Blue Cross eligibility and benefits through the OMNIPRO system, Medicaid through the EMEVS system on a daily basis and contact employers, ... patients with no third party payment source with a Medicaid application and a list of documents required for...patient appointments, in advance per the guidelines to maximize reimbursement and allow surgeons ample time to review test… more
- Humana (Springfield, IL)
- …and/or other related functions in healthcare/health insurance + Experience with IL Medicaid and D-SNP + Experience working with key provider types (primary care, ... hospitals, nursing facilities, and/or HCBS and LTSS providers) + Knowledge of Medicaid Long Term Support Services, (LTSS), waiver claims + Partners with Provider… more