- CVS Health (Lexington, KY)
- …we do it all with heart, each and every day. **Program Overview** Join our Aetna team as we lead the way in providing exceptional care to dual eligible ... (DSNP) members, who are enrolled in both Medicare and Medicaid and face a variety of complex health and...member-centered care planning process alongside the other core care team members. Your responsibilities will include: + Conducting field… more
- Elevance Health (TN)
- …Skills, Capabilities and Experiences:** + Possession of DEA registration or eligibility preferred. + **Active Tennessee Medicaid license highly preferred** ... modalities to patients who receive home and community-based services through state Medicaid programs, dual eligible members and other membership as assigned by our… more
- Devereux Advanced Behavioral Health (Orlando, FL)
- …at Devereux, you will: put the needs of others first, feel called to serve and called to lead . As a member of our team , you will be a significant part of our ... for new MDs and ARNPs joining MMA plans. + Apply for Florida Medicaid numbers for providers during onboarding. + Complete special projects within designated… more
- CVS Health (Helena, MT)
- …recruiting for an exciting opportunity to join it's CVS Health's leadership team as a Director, Pharmacy Benefit Management (PBM) Underwriting, Analysis and ... Strategy. In this role, you will lead a critical segment supporting a strategic PBM client...a deep understanding of PBM financial levers within Commercial, Medicaid , Medicare Part D, and Public Exchange lines of… more
- Cognizant (Cheyenne, WY)
- …visa transfer or sponsorship now or in the future **Responsibilities** . Lead the development and optimization of infrastructure solutions using Splunk Admin and ... to ensure seamless operation and support of Medicare and Medicaid Claims processing. . Provide expert guidance on infrastructure...knowledge sharing and continuity. . Mentor and support junior team members to foster a culture of learning and… more
- Elevance Health (St. Louis, MO)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...enhance quality, efficiency, and training. + Participate in all team meetings, staff meetings, and training sessions. + Assist… more
- Intermountain Health (South Jordan, UT)
- …external relationships, and demonstrates problem-solving and compliance knowledge, including Medicare/ Medicaid billing and privacy regulations. + Audits casework and ... and cross-functional initiatives. + Maintains productivity standards, obtains insurance eligibility using phone and online tools, and translates diagnoses into… more
- CVS Health (Hartford, CT)
- …Aetna is looking for a medical director to be part of a centralized team that supports the Medical Management staff ensuring timely and consistent responses to ... medical director will participate in and be able to lead daily rounds. **Required Qualifications:** Minimum 3-5 years of...+ years of experience in managed care (Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS… more
- UPMC (Pittsburgh, PA)
- …Medical Assistance! Additionally, CHC is also for individuals that qualify for Medicare, Medicaid , or require a nursing facility level of care. The CHC Service ... Responsibilities: + Establish and build strong relationships with both internal team members and partner provider foster a collaborative environment. Educates on… more
- Boehringer Ingelheim (Ridgefield, CT)
- …filled; cultivate network by facilitating cross department communication and projects. + Lead team toward continuous improvement and/or process design through ... include, but are not limited to: identification of duplicate payments with Medicaid claims, diversion analysis, good faith resolution with covered entities, working… more