• Credentialing Spec

    Covenant Health Inc. (Knoxville, TN)
    Overview Credentialing Specialist , Business Office Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... This position is responsible for prioritizing and managing tasks in the Knoxville Business Office Services (KBOS), Billing Department regarding Out of State … more
    Covenant Health Inc. (10/14/25)
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  • LVN UM Delegation Oversight Nurse Remote based in

    Molina Healthcare (Long Beach, CA)
    …with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... CMS, and NCQA requirements, as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will...in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid , National Committee… more
    Molina Healthcare (11/21/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (TX)
    …with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... and cost-effective member care. This position will support our Corporate Compliance business . The candidate must have an unrestricted LVN licensure. Candidates must… more
    Molina Healthcare (11/13/25)
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  • Senior Clinical Pharmacist - Pipeline

    Humana (Annapolis, MD)
    …well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, including ... residency or similar pharmacy practice experience + Board Certified Pharmacotherapy Specialist (BCPS) + MBA, pharmacoeconomics or health outcomes training + An… more
    Humana (11/20/25)
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  • Financial Analyst, Onsite

    Trinity Health (Gaithersburg, MD)
    …Medicare, Medicaid , and electronic filing strongly preferred. + Strong business acumen, problem-solving skills, and ability to work independently. + Excellent ... in Gaithersburg, Maryland - Full Time** **Position Purpose** The Financial Operations Specialist supports the financial operations of one or more Trinity Health PACE… more
    Trinity Health (11/14/25)
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  • Print & Financial Services Project Manager

    Waystar (Louisville, KY)
    **ABOUT THIS POSITION** The role of the Print and Financial Services Specialist Project Manager is to plan, execute, and finalize project tasks associated with ... with the Patient Tools. The Print and Financial Services Specialist is responsible for coordinating the efforts of project...of project estimated revenue prior to transition of the business account. **WHAT YOU'LL DO** + Ability to comprehend… more
    Waystar (10/28/25)
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  • Bilingual Call Center Rep (Relationship…

    Healthfirst (NY)
    …complete outbound calls according to approved scripts.** + **Searches ePACEs for Medicaid eligibility, exclusion, and exemption codes.** + **Searches in Marx (CMS) ... all field and tele video conference appointments for HF CompleteCare Specialist and Intake Nurses in Salesforce.** + **Schedules Entitlement Advocates appointments… more
    Healthfirst (11/21/25)
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  • Transplant Financial Coordinator - Transplant…

    Sharp HealthCare (San Diego, CA)
    …candidates, marketplace factors, other requirements for the position, and employer business practices. **What You Will Do** The Transplant Financial Coordinator ... for transplants by providing guidance on fundraising, completion of Medicare/ Medicaid /disability applicants, indigent funding, etc.Perform post-transplant billing counseling services… more
    Sharp HealthCare (11/05/25)
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  • RN, Field Care Manager

    Humana (Salem, VA)
    …meet their needs. + Collaborates with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for health-related social needs ... or whichever is higher. **Preferred Qualifications** + Prior experience with Medicare, Medicaid and dual eligible populations. + Bachelor's Degree Nursing (BSN). +… more
    Humana (11/13/25)
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  • Information and Eligibility Manager (Orange)

    Community Based Care of Brevard, Inc. (Orlando, FL)
    …serves as a liaison for Adoption, Foster Board, GAP, and as a Medicaid information resource. ESSENTIAL FUNCTIONS: Monitor and supervise information and eligibility ... specialist staff including tasks specific to Dependency, Adoption, and...GAP Monitor, approve and supervise client eligibility activities for Medicaid and Federal Funds Approve placement and payment information… more
    Community Based Care of Brevard, Inc. (10/12/25)
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