- State of Minnesota (St. Paul, MN)
- **Working Title: Medicaid Management Information Systems (MMIS) Supervisor** **Job Class: Systems Supervisor** **Agency: Minnesota IT Services** + ... illness, chemical dependencies, and physical or developmental disabilities. As the Medicaid Management Information Systems Supervisor, you will supervise… more
- Humana (St. Paul, MN)
- …Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other ... medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (St. Paul, MN)
- …Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other ... medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (St. Paul, MN)
- …Citrix, Microsoft Azure Virtual Desktop, and others). + Oversee the lifecycle management of virtual systems , including provisioning, patching, upgrading, and ... with Humana Government Business is contingent upon your having access to government information and systems ** + 7+ years of hands-on experience in virtualization… more
- Humana (St. Paul, MN)
- …pipelines, ensuring adherence to best practices in accountable AI for effective risk management and measurement. Join us in shaping the future of healthcare through ... AI excellence. We are building advanced agentic systems capable of autonomously managing and decomposing complex goals. We are seeking an expert in agent design,… more
- CVS Health (St. Paul, MN)
- …actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job ... data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid … more
- Humana (St. Paul, MN)
- …system. Ensure all paperwork and documentation is notated within the clinical management system. + ASN with care coordination efforts of assigned beneficiary ... permanent status. Ensure documentation is accurate and documented in all applicable systems . Be able to communicate ECHO requirements to beneficiaries to ensure they… more
- Cognizant (St. Paul, MN)
- …Medicaid , and third-party guidelines. + Effectively document and log claims/appeals information on relevant tracking systems + Utilize critical thinking ... by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the...Plan **_Disclaimer_** : The salary, other compensation, and benefits information is accurate as of the date of this… more
- Humana (St. Paul, MN)
- …Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other ... medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and analytic methods. * Assists in the implementation of new products and systems by providing actionable information and recommendations that evaluate the ... requires expertise in healthcare data-including claims, membership, and provider information -along with hands-on experience in risk adjustment models, HCC analysis,… more