- Molina Healthcare (Omaha, NE)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST will require ... (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines… more
- Molina Healthcare (Kenosha, WI)
- …Act** cases in accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for the ... (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines… more
- Centene Corporation (Atlanta, GA)
- …compliance, accreditation, service or quality improvement Complex project management experience Preferred **Experience with Medicare and/or NCQA preferred :** ... on workplace flexibility. **Position Purpose:** The Senior Quality Improvement Specialist is responsible for coordinating assigned regulatory, accreditation, clinical… more
- Molina Healthcare (Savannah, GA)
- … Education** Preferred field: Clinical Quality, Public Health or Healthcare. ** Preferred Experience** 1 year of experience in Medicare and in Medicaid. ... accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one or… more
- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** Arrhythmia Nurse Specialist **Cost Center:** 301351038 Mfld-Cardiology **Scheduled Weekly Hours:** 40 **Employee ... the field of cardiology, especially in the field of arrhythmias. ** Preferred /Optional:** None **EXPERIENCE** **Minimum Required:** Three to five years' experience in… more
- Banner Health (Peoria, AZ)
- …that sets us apart from the competition. As a Post Acute Alignment Specialist , you will be optimizing referral development for **Home Health, Home Medical Equipment ... key accounts. Must have strong knowledge of governmental regulations, Medicare eligibility requirements, comprehensive understanding of potential care plan needs… more
- Hackensack Meridian Health (Hackensack, NJ)
- …serve as a leader of positive change. The **Integrated Case Management Specialist ** performs selected services and functions related to insurance management with ... hour discharge report and providing patients with the IM Letter from Medicare prior to discharge. **Education, Knowledge, Skills and Abilities Required:** + High… more
- Atlantic Health System (Morristown, NJ)
- …+ 2-5 years of Emergency Department experience as a nurse educator or relevant. Preferred : + 2-3 years of previous Clinical Specialist or Nurse educator ... in Advanced Practice Nurse (APRN) + National Certification strongly preferred At Atlantic Health System, our promise to our...highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its… more
- Mayo Clinic (Rochester, MN)
- …customer service. Must be able to work independently as needed. Knowledge of Medicare , Medicaid and/or private insurance billed preferred with attention to ... Competitive retirement package to secure your future. **Responsibilities** The HME Specialist I position is the first of multiple career opportunities within… more
- Penn Medicine (Philadelphia, PA)
- …Penn Presbyterian Medical Center is seeking a full-time Clinical Pharmacy Specialist , Opioid Stewardship. This position is responsible for provision of comprehensive ... Implement and maintain clinical pharmacy programs that support meeting Medicare Core Measures. Effectively utilize information technology to enhance pharmacotherapy… more