- Humana (Frankfort, KY)
- …responsible for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare , and DSNP states, while maintaining adherence to all ... Lead is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with… more
- Nuvance Health (Danbury, CT)
- …standards to assure compliance with all third party payers including Commercial, Medicare and Medicaid programs. Credentials and re-credentials all WCHN ... CT Department of Health Services and regulatory requirements for the Centers for Medicare & Medicaid services and state requirements. This includes completing… more
- Catholic Health Services (Rockville Centre, NY)
- …complex data analysis. The ideal candidate possesses in-depth knowledge of Medicare / Medicaid reimbursement, managed care contracts, and healthcare finance. Key ... Responsibilities: + Prepare and review Medicare , Medicaid , and other third-party cost reports, ensuring accuracy and regulatory compliance. + Analyze… more
- Genesis Healthcare (NJ)
- …Manager in an assigned nursing center. This individual manages the Medicare / Medicaid reimbursement process through evaluating, enhancing, and training nursing ... priorities in the nursing center and reviews outcomes. *Evaluates the Medicare and Medicaid processes monthly to assure proper utilization of services to… more
- Humana (Boise, ID)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Charleston, WV)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Jefferson City, MO)
- …hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid , or Commercial health insurance. +… more
- Humana (Clermont, IN)
- …Community Based Services waivers (HCBS dual roles only) + Prior experience with Medicare & Medicaid recipients + Experience working with a geriatric population ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Avera (Fargo, ND)
- …Manager will be responsible for the oversight of reimbursement associated with the Medicare , Medicaid , Tricare and any other governmental cost reports and ... hospitals, clinics, home healths, hopices, and nursing homes. Oversight includes the Medicare , Medicaid and Tricare cost reports for all entities in the Avera… more
- University of Southern California (Los Angeles, CA)
- …reimbursement, focusing on tasks such as preparing and ensuring compliance with the Medicare Cost Report (MCR) and related Medicaid Cost Reports. Additionally, ... issues to the Manager as needed. + Monitor and interpret CMS, Medicare , and Medicaid reimbursement, including proposed and final IPPS and OPPS rules, CMS… more