- Capgemini (Cincinnati, OH)
- …**Program Manager / Sr Project Manager** - Markets and Growth portfolio Medicare Advantage/ DSNP/ Medicaid or Exchange program/ product build knowledge ( ... Enrollment , Eligibility, Claims, Provider network, encounters etc) (Highly Recommended having exposure to one or many functions) E2E set of Pharmacy Benefits… more
- Virtua Health (Marlton, NJ)
- …the CAQH (Council for Affordable Quality Healthcare) and PECOS (Provider Enrollment Chain and Ownership System) databases to ensure accurate clinician information ... to maintain and update the 855B roster of all practices locations for Medicare and Medicaid to obtain payer recredentialing for over 550 clinicians Manages the… more
- Humana (Chicago, IL)
- …systems for claims processing, underwriting, policy administration, and member enrollment . Projects often focus on automating workflows, modernizing legacy ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Houston Methodist (Houston, TX)
- …practice practitioners (APPs). Duties for this position include credentialing and enrollment in governmental and commercial managed care plans and medicare ... and medicaid. The Managed Care Credentialing Specialist position has consistent interaction with the new providers, Administrators, health plans (commercial and governmental), and the department. **PEOPLE ESSENTIAL FUNCTIONS** + Provides information to… more
- Trinity Health (Columbus, OH)
- …, a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive outreach and ... + Relocation assistance (geographic restrictions apply) + Discounted tuition and enrollment opportunities' at the Mount Carmel College of Nursing **Why Columbus?**… more
- Trinity Health (Columbus, OH)
- …, a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive outreach and ... + Relocation assistance (geographic restrictions apply) + Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing + Mount… more
- CVS Health (Bayonne, NJ)
- …daycare, personal care assistants, nursing facility services, and MLTSS enrollment . + Collaborate with members, their representatives, primary care providers, ... management** or **discharge planning** . + Background in **managed care** , **Medicaid/ Medicare ** , or **LTSS** . + Proficiency with **Microsoft Office Suite**… more
- Commonwealth Care Alliance (Boston, MA)
- …have):** + clinical license/certification (ie, LPN, Medical Assistant, CHW) **MA Health Enrollment ** **(required if licensed in Massachusetts):** + No, this is not ... 5+ years' experience working in health care + Experience with a Medicare Advantage population preferred. + Experience with Substance Use Disorders **Required… more
- Commonwealth Care Alliance (Boston, MA)
- …state assigned; may require multiple state licenses based on product **MA Health Enrollment ** **(required if licensed in Massachusetts):** + Yes, this is required if ... Experience (nice to have):** + Experience working in a health plan, with Medicare Advantage and/or dually eligible population + Experience with a care management… more
- Penn Medicine (Philadelphia, PA)
- …tasks, workflow, phone calls and/or email + Obtains information to complete Medicare Secondary Payer Questionnaire and other payer specific documents as required + ... payments on deposits due, which may include screening of patients for enrollment in available credit option programs. + Effectively communicates with payer to… more