- Idaho Division of Human Resources (ID)
- …EXAMPLE OF DUTIES: + Analyzes claims data and reports to identify Medicaid provider and participant utilization patterns that may indicate program abuse. + ... crucial role in conducting preliminary investigations by reviewing claims data and medical records, reviewing provider billing...state Medicaid agency or working for a Medicaid provider in a position that required… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …program policy. Manages the Prior Authorization Liaison (PAL) referral process for assigned Medicaid programs to ensure compliance. No Civil Service test scoreis ... May provide functional supervision in accordance with the Civil Service Allocation Criteria Memo. Location of Work: Department of Health and Hospitals.… more
- Mathematica (Columbus, OH)
- …related to monitoring and improving the following Medicaid programs: Medicaid payment and financing policies (fee-for- service base and supplemental payments, ... rigorous analytic thinking to the collection and interpretation of quantitative and qualitative data , including analysis of Medicaid administrative data and… more
- MyFlorida (Tallahassee, FL)
- …- 60064452 - ESS Medicaid Policy Specialist 1 1 Pay Plan: Career Service Position Number: 60064452 Salary: $42,000 min to $52,000 max - based on relevant ... GOVERNMENT OPERATIONS CONSULTANT II - 60064452 - ESS Medicaid Policy Specialist 1 1 Date: Sep 30,...travel will be required. This is a full-time Career Service position, working 40 hours per week. Regular business… more
- New York State Civil Service (Albany, NY)
- … research, including SQL Developer and eMedNY, to aid in the development of Medicaid managed care audits; analyze data and make well-reasoned determinations for ... NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title...outside the United States or its territories, you must provide independent verification of equivalency. This information can be… more
- Humana (Columbus, OH)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... first** Humana Healthy Horizons is seeking exceptional candidates to join our Medicaid Product Strategy Organization to advance Humana's Medicaid products and… more
- Humana (Columbus, OH)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize,… more
- Public Consulting Group (Columbus, OH)
- …new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight and direction for scope, ... achieve strategic goals to serve the public better. We provide the full spectrum of technology consulting services to...Business Enablement + Business Solutions + Project Assurance The Medicaid marketplace is changing, and PCG is at the… more
- Humana (Cincinnati, OH)
- …healthcare operations, particularly around claims processing, enrollment, provider data management and clinical operations; Medicaid preferred + ... The Lead drives solutions at an organizational level to provide maximum value and align to the overarching IT...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- Robert Half Accountemps (Southampton, MA)
- …* Regularly update and maintain customer credit records. * Handle inquiries related to Medicaid billing and provide resolution to any issues. * Accurately input ... Description We are offering an opportunity for a Medicaid Claims specialist in Southampton, Massachusetts. This role...data and manage numeric data entries. * Ensure the correct interpretation and application… more
- Humana (Columbus, OH)
- …The key responsibilities of the role include: + Refresh Medicaid inpatient data and tool monthly to provide best estimate utilization/PMPMs for the month ... for Medicaid markets The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around… more
- Louisiana Department of State Civil Service (Monroe, LA)
- MEDICAID PROGRAM MONITOR Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4677806) Apply MEDICAID PROGRAM MONITOR Salary $4,177.00 - ... position and may be filled as a Probationary or Promotional appointment. No Civil Service test score is required in order to be considered for this vacancy. To… more
- Staffing Solutions Organization (Albany, NY)
- …of policy, the Medicaid Program Advisor will: conduct a range of Medicaid provider compliance activities to determine compliance with the federal HCBS final ... to support the Department's and Office's goals and objectives. Provide excellent customer service in conducting all...supports, both nationally and within NYS. *Collect and analyze data , using sound analytic skills to provide … more
- National Health Care Associates (Marlborough, CT)
- …We invite you to join our team! **-** **What You'll Do:** As a Medicaid Specialist, you will support the center's business office in processing Medicaid ... to the financial stability of our organization, ensuring resources are optimized to provide the best care for our residents. **Key Responsibilities:** + Process and… more
- Abbott House (Bronx, NY)
- …Facilitate a single case agreement when a child is placed outside of the MMCP's service area or provider network Interact with clinical and billing staff Refer ... Job Summary: The Medicaid Managed Care Liaison is the primary contact...children for needed services and assist in provider selection Coordinate with health care providers, including school… more
- Humana (Columbus, OH)
- …The Business Intelligence Engineer 2 solves complex business problems and issues using data from internal and external sources to provide insight to ... to collect, integrate, analyze, and present an organization's raw data in order to create insightful and actionable business...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- Staffing Solutions Organization (Albany, NY)
- …analytic exercises, and provide insight into the management and quality of data in the NYS Department of Health's Medicaid program. Comprehensive on-the-job ... Medicaid Program Advisor One Commerce Plaza, Albany, 99...Service Management principles preferred + Database architecture and data management experience preferred + Project Management certification or… more
- City of New York (New York, NY)
- …ARE HIRED PROVISIONALLY IN THIS TITLE, YOU MUST TAKE AND PASS THE CIVIL SERVICE EXAM, WHEN IT BECOMES AVAILABLE, TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. Infoline is ... HRA's telephone service center, which provides information on HRA's programs to...who speak to callers directly and are able to provide case specific information. Constituents can call the Infoline… more
- Conduent (Topeka, KS)
- …policies and procedures, call center processes, and other content related to Medicaid data entry and registration. Will continually measure training needs, ... of a culture where individuality is noticed and valued every day. ** Medicaid Eligibility Trainer** **Hourly rate $19.82/hr** Conducts training classes for employees… more
- MyFlorida (Tallahassee, FL)
- SENIOR MANAGEMENT ANALYST SUPV - SES - 60046107 - ESS Medicaid Unit Date: Oct 1, 2024 The State Personnel System is an E-Verify employer. For more information click ... MANAGEMENT ANALYST SUPV - SES - 60046107 - ESS Medicaid Unit Pay Plan: SES Position Number: 60046107 Salary:...(minimum 4 years). + + Note: Be prepared to provide a copy of your degree/diploma or request official… more