- Magnolia Health Systems (Columbus, IN)
- …regulations which are relevant to job responsibilities. Demonstrates understanding of Medicare Hospice & Long-Term Care regulations including HIPAA Privacy Standards ... requirements required to perform duties according to state and federal requirements ( Medicare Conditions of Participation). + CPR and First Aid certification or the… more
- UCHealth (Pueblo, CO)
- …practice. + Eligible to provide reimbursable services and maintain provider status with Medicare and Medicaid. + Eligible to provide services with no sanctions or ... practice. + Eligible to provide reimbursable services and maintain provider status with Medicare and Medicaid. + Eligible to provide services with no sanctions or… more
- UCHealth (Longmont, CO)
- …+ Eligible to provide services, reimbursable services, and maintain provider status with Medicare and Medicaid. + Eligible to provide services with no sanctions or ... + Eligible to provide services, reimbursable services, and maintain provider status with Medicare and Medicaid. + Eligible to provide services with no sanctions or… more
- Gentiva (Cary, NC)
- …operations, ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure ... operations leadership + Strong understanding of hospice regulations, compliance, and Medicare conditions of participation + Proven ability to manage teams, budgets,… more
- Health Care Service Corporation (Chicago, IL)
- …REQUIREMENTS** : + Bachelor Degree in Business OR 2 years' experience with health insurance . + 1 year of experience with health insurance benefits and/or ... operations. + Knowledge of Medicaid and Medicare product(s). + Verbal and written communication skills. +...+ 1+ year experience writing contracts + Knowledge of Medicare product(s) not needed. \#LI-FW1 \#LI-KH1 \#LI-Hybrid **This is… more
- Humana (Oklahoma City, OK)
- …+ Health Plan experience working with large carriers + Previous Medicare /Medicaid experience a plus + Previous experience in pre-authorization, utilization ... off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is… more
- State of Indiana (Indianapolis, IN)
- …Overview: This role will effectively manage the Medicaid and Children's Health Insurance Plan (CHIP) state plan amendment process ensuring compliance with all IHCP ... programs, the Code of Federal Regulations, Indiana Code, and Centers for Medicare and Medicaid Services (CMS) requirements. You will collaborate with FSSA and… more
- PeaceHealth (Vancouver, WA)
- …Provide utilization management including facilitating appropriate status assignment per Medicare and InterQual criteria. Ensure appropriate documentation for medical ... payer criteria to ensure conformance with payer standards and provide insurance reviews. Implement opportunities to improve effectiveness in utilization. + Provide… more
- Humana (Topeka, KS)
- …communication and interpersonal skills. **Duties Include** + Telephonically work with Medicare members with transitional needs and complex chronic conditions. + ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 10-22-2025 **About us**… more
- Humana (Honolulu, HI)
- …to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group Account members and create actionable and ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us**… more