- Fallon Health (Worcester, MA)
- …we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid , and PACE- in the region. **Brief summary of ... Assists in the conversion of participants from community based Medicaid to long-term care Medicaid when necessary....from community based Medicaid to long-term care Medicaid when necessary. Works collaboratively with the Operations Support… more
- Insight Global (Indianapolis, IN)
- …in financial or operational analysis, especially with complex data sets Medicare / Medicaid cost reporting (MAC, reimbursement consulting firm, hospital, ... include reviewing 6-8 cost reports prepared by team members, and handling Medicaid DSH Eligibility and HSL surveys. You will coordinate projects, analyze financial… more
- Insight Global (Indianapolis, IN)
- …or operational analysis experience, especially with complex data sets. 3-5 years Medicare / Medicaid software GME reimbursements Related party principles Indianan ... the completion of Models 3-4 times annually. Additionally, you will handle Medicaid DSH Eligibility and HSL surveys, contributing to compliance and reimbursement… more
- New York State Civil Service (Schenectady, NY)
- …eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining ... 12304 Duties Description OPWDD is required by law to have an effective Medicaid Compliance Program in place. Proactive efforts and resources are needed to mitigate… more
- University of Southern California (Alhambra, CA)
- …provider billing, medical records, charge audit environment, CDM maintenance, Medicare / Medicaid reimbursement, managed care contractual arrangements, and patient ... provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date....(Keck & Norris) ensuring all annual updates required by Medicare and other third-party payers are up to date.… more
- Humana (Boise, ID)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... submission of bids to support Humana's pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial… more
- Humana (Sacramento, CA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you… more
- Humana (Helena, MT)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... You'll play a key role in shaping financial insights, supporting Medicare -related initiatives, and guiding analytical projects that impact business outcomes. +… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare - Medicaid plans)_** + **_Experience managing external audits and communicating ... for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to… more
- The Cigna Group (St. Louis, MO)
- …position will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, ... adjudication and other PBM operations + Experience in managing capabilities in Medicare and Medicaid preferred + Preferred, but not required to have knowledge in… more