- Public Consulting Group (Columbus, OH)
- …(CMS) and the new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight ... changing, and PCG is at the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our growth efforts. Deep Medicaid… more
- Public Consulting Group (Sacramento, CA)
- …with proposal development **Qualifications** Required Skills/Experience * Experience with Medicaid Infrastructure Technology Architecture (MITA) * 5+ years of ... within a large organization Desired Skills/Experience * Experience with Federal Certification guidelines and processes, such as Outcomes Based Certification … more
- MyFlorida (Fort Lauderdale, FL)
- 68048395 - GOVERNMENT OPERATIONS CONSULTANT II Date: Jul 1, 2024 Location: FT LAUDERDALE, FL, US, 33309 The State Personnel System is an E-Verify employer. For more ... for Health Care Administration Working Title: 68048395 - GOVERNMENT OPERATIONS CONSULTANT II Pay Plan: Career Service Position Number: 68048395 Salary: $1,645.27… more
- Highmark Health (Annapolis, MD)
- …job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support ... to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control… more
- Nuvance Health (Fishkill, NY)
- …and Qualifications + Active registered nurse license + Active internationalboard-certifiedlactation consultant (IBCLC) certification + Must be eligible to be ... Per Diem Lactation Consultant Location: Fishkill, NY, United States Requisition ID:...credentialed with Medicaid /Medicare + Basic computer literacy + Excellent interpersonal, communication,… more
- Molina Healthcare (Luck, WI)
- …community who are enrolled in the Wisconsin IRIS Program and the TMG IRIS Consultant Agency. While your office will be home-based, you will have regularly scheduled ... participants in their home and community. As an IRIS Consultant (IC), you will build relationships with the people...most out of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people… more
- WellSense (Boston, MA)
- Sr. Provider Relations Consultant - (MA residents)-$5000 sign on bonus WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide… more
- MyFlorida (Tallahassee, FL)
- 68061372 - HEALTH SERVICES & FACILITIES CONSULTANT Date: Jul 1, 2024 Location: TALLAHASSEE, FL, US, 32308 The State Personnel System is an E-Verify employer. For ... Care Administration Working Title: 68061372 - HEALTH SERVICES & FACILITIES CONSULTANT Pay Plan: Career Service Position Number: 68061372 Salary: $1,742.64 biweekly… more
- Humana (Washington, DC)
- …Management, Strategy Alignment, Strategy Reporting and Change Management. The Corporate Strategy Consultant will work with company leaders at all levels of the ... and, at times, lead enterprise-wide strategic initiatives. The Corporate Strategy Consultant will also report progress to strategy leadership and the executive… more
- City of New York (New York, NY)
- …with essential benefits such as Cash, Food and Rental Assistance as well as Medicaid . The Office of the Medical Director aims to improve the health and well-being ... one (1) City Medical Specialist (Per Diem) to function as a Medical Consultant who will: - Indirectly supervise contracted clinical staff, share policies and… more
- University of Washington (Seattle, WA)
- …natural beauty. **Department of Emergency Medicine has an outstanding opportunity for Research Consultant .** The University of Washington (UW) is proud to be one of ... screening for social determinants of health, and evaluating the impact of the Medicaid Transformation Project on ED utilization in King County. This position will be… more
- CVS Health (Columbus, OH)
- …more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state.Normal ... Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan,… more
- VHC Health (Arlington, VA)
- Quality Consultant - PeriOp or Critical Care Job Description Purpose & Scope: The Quality Consultant is responsible for supporting the organization in four ... in regulatory compliance and continuous quality improvement is preferred. Certification /Licensure: None VHC Health (TM) has provided exceptional medical services… more
- Centers for Independence (Fond Du Lac, WI)
- **IRIS Consultant Case Manager - Milwaukee county** **Job Details** **Job Location** MCFI Main Campus - Milwaukee, WI **Position Type** Full Time **Education Level** ... in the IRIS program. The role of the IRIS Consultant (IC) is to assist participants in self-directing services...for completing the Long Term Care Functional Screen (LTCFS) certification and completing annual and rescreens for their participant… more
- CVS Health (Columbus, OH)
- …Medicare/ Medicaid populations* MCG experience* Managed care experience* UM Certification * MedCompass Education * Minimum of an Associate's Degree in Nursing* ... personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any… more
- CVS Health (Lansing, MI)
- …of Medicare/ Medicaid Managed care experience Med Compass Experience CM/UM Certification Education Associates Degree in NursingBSN preferred Pay Range The typical ... is required.Applicants from any state can apply. Prior Authorization UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to… more
- PruittHealth (Pensacola, FL)
- …the care provided. * Utilization of skilled Medicare services * Medicare RUG, Medicaid Case Mix CMI / or Skilled Level of Care management **KEY RESPONSIBILITIES:** ... clinical responsibility and experience with RAI process (MDS) required **MINIMUM LICENSURE/ CERTIFICATION REQUIRED BY LAW:** Current, active license as a Registered… more
- Molina Healthcare (Owensboro, KY)
- …urgency, communication and follow through to closure. * Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO contract ... Belt PMI - Project Management Professional (PMP) Agile Product Owner Design Thinking Certification **PHY** **S** **I** **C** **AL DEM** **A** **N** **D** **S** **:**… more
- Sutter Health (Sacramento, CA)
- …but not limited to, the California Knox-Keene Act and Centers for Medicare & Medicaid Services (CMS) alternative payment models. Works with and serves in the absence ... or diploma Bachelor's in Business Administration or related field ** CERTIFICATION & LICENSURE:** CHC -Certified in Healthcare Compliance **TYPICAL EXPERIENCE:**… more