• Eligibility Specialist

    ALWAYS COMPASSIONATE HEALTH (Melville, NY)
    …with government agencies, and ensures that all documentation is in compliance with regulatory requirements. The Eligibility Specialist also collaborates with intake ... + Educate clients and families about available services, insurance options ( Medicare /Medicaid/private pay), and care plan logistics + Assist clients in navigating… more
    ALWAYS COMPASSIONATE HEALTH (09/27/25)
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  • Home Health Licensed Practical Nurse LPN PRN

    Aveanna Healthcare (Dade City, FL)
    …at all times. Essential Job Functions + Deliver quality patient care in compliance with physician orders under direction of their Registered Nurse teammate. * Perfom ... the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (09/27/25)
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  • Utilization Management Nurse

    Humana (Cheyenne, WY)
    …reviewing criteria to ensure appropriateness of care preferred + Previous Medicare experience a plus + Milliman MCG experience preferred **Additional Information** ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/26/25)
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  • Telephonic Nurse Care Manager

    Humana (Springfield, IL)
    …care experience. + Certified Case Manager (CCM). + Prior experience with Medicare & Medicaid recipients. + Experience with health promotion, coaching and wellness. ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/26/25)
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  • Senior Vendor Management Professional

    Humana (Pierre, SD)
    …+ **Prior experience in a healthcare or insurance setting** + **Knowledge of Medicare Advantage** + **Grievance and Appeals experience** + **Experience working in a ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/26/25)
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  • Consumer Service Operations Representative III

    Humana (West Palm Beach, FL)
    …environment + CNA or Medical Assistant experience + Quality experience + Medicare experience + Familiarity with medical terminology and/or ICD-10 codes **Additional ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/26/25)
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  • Provider Transformation Specialist (RN- Western…

    Highmark Health (Buffalo, NY)
    …outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual gain/risk share ... for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities. + Function as the… more
    Highmark Health (09/26/25)
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  • Patient Access Representative 1

    Trinity Health (Grove City, OH)
    …relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare , Medicaid and other ... collection when registering patients + Using EPIC + Demonstrates understanding of Medicare , Medicaid and other third party information requirements and adheres to… more
    Trinity Health (09/26/25)
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  • Home Health Licensed Practical Nurse LPN Full Time

    Aveanna Healthcare (Marietta, GA)
    …and Douglas County Essential Job Functions + Deliver quality patient care in compliance with physician orders under direction of their Registered Nurse teammate. * ... the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (09/26/25)
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  • BH Care Coordinator

    WellSense (Boston, MA)
    …health insurance company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as ... the designated medical management information system (eg Jiva) ensuring compliance with contractual requirements, internal policy, and accreditation standards.** +… more
    WellSense (09/26/25)
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