• Executive Director, Chief Actuary

    Banner Health (Phoenix, AZ)
    …Hospital leadership. Will direct the preparation of rate filings to Centers for Medicare and Medicaid Services (CMS), Health and Human Services (HHS), Arizona's ... needed. Knowledge of health care and state government, familiarity with Medicaid , Commercial and Medicare related products. Demonstrated leadership capabilities,… more
    Banner Health (11/22/25)
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  • Clinical Revenue Auditor-CDM Patient Financial…

    Mount Sinai Health System (New York, NY)
    …Knowledge of insurance and governmental programs, regulations, and billing processes (eg, Medicare , Medicaid , etc.), managed care contracts and coordination of ... **Licensing and Certification Requirements** : + Current NYS licensure ( RN , OT, PT, SLP, PA, Social Worker, Laboratory Technologist,...compliance regulations set by entities like the Centers for Medicare and Medicaid Services (CMS). + Mitigate… more
    Mount Sinai Health System (12/24/25)
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  • Case Manager- Spooner

    Humana (Webster, WI)
    …environment in accordance with the MCP. + Collaborate continuously with a Field Care Nurse ( RN ) to review and update care plans and address members' evolving ... service agencies and additional community resources + Prior experience with Medicare & Medicaid recipients **Additional Information** + **Workstyle:** This… more
    Humana (12/23/25)
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  • Director of State Government Affairs

    Commonwealth Care Alliance (Boston, MA)
    …or health care policy. + A minimum of three (3) years of experience with Medicaid & Medicare managed care and other public health care programs is required. ... (nice to have):** + 2-4 years' experience as a registered lobbyist/advocate. + Public Speaking + Charitable giving experience...(must have):** + Strong passion for and interest in Medicare / Medicaid , disability and social policy and advocacy… more
    Commonwealth Care Alliance (10/21/25)
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  • BH Provider Engagement Program Manager

    Commonwealth Care Alliance (Boston, MA)
    …experience required. Required Experience (must have): * 5+ years * Experience with Medicaid and Medicare products and programs * Experience or knowledge of ... making in alignment with clinical licensure. * Strong understanding of Medicare , Medicaid (MassHealth), and dual-eligible program operations, including… more
    Commonwealth Care Alliance (10/18/25)
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  • LTSS Program Specialist, Hybrid

    Commonwealth Care Alliance (Boston, MA)
    …to learn new systems and databases that CCA implements. * Working knowledge of Medicare and Medicaid (MassHealth) * Familiarity with and full support of ... ability to handle multiple projects. * Strong understanding of Medicare , Medicaid , duals program, and health plan...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
    Commonwealth Care Alliance (10/18/25)
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  • RN - Operations - Home Health & Hospice

    Marshfield Clinic (Iron Mountain, MI)
    …None **EXPERIENCE/KNOWLEDGE/SKILLS/ABILITIES** **Minimum Required:** Two years of experience as a Registered Nurse or one year of experience in a ... are substantially related to the position._ **Minimum Required:** Current Registered Nurse in the State of Michigan,...excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition… more
    Marshfield Clinic (12/31/25)
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  • RN - Operations - Home Health & Hospice…

    Marshfield Clinic (Iron Mountain, MI)
    …None **EXPERIENCE/KNOWLEDGE/SKILLS/ABILITIES** **Minimum Required:** Two years of experience as a Registered Nurse or one year of experience in a ... are substantially related to the position._ **Minimum Required:** Current Registered Nurse in the State of Michigan,...excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition… more
    Marshfield Clinic (12/03/25)
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  • Temporary to Hire Prior Authorization RN

    Fallon Health (Worcester, MA)
    …degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of ... be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid , and PACE (Program of All-Inclusive...three to five years clinical experience as a Registered Nurse in a clinical setting required.… more
    Fallon Health (12/14/25)
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  • Afterhours RN Care Manager

    Gentiva (Tukwila, WA)
    …proud to be an EEO employer + We maintain a drug-free workplace ReqID: 2025-132150 Category: Registered Nurse Position Type: Full-Time Company: Gentiva Hospice ... auto insurance **Skills and Competencies** + Strong knowledge of hospice principles, Medicare / Medicaid regulations, and best practices + Ability to conduct… more
    Gentiva (12/30/25)
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