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Be an instrumental part of Corporate Affairs at Humana by assisting in the development of Humana’s public policy positions for our public payer businesses with an emphasis on Medicaid, dual eligible policy, and future state public health programs.
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Work experience applying evidence-based criteria (i.e.: MCG, lnterqual); Health plan medical policy / clinical coverage guidelines. Knowledge of CMS (Centers for Medicare and Medicaid Services) coverage policies required.
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This opening if for a Social Services Program Specialist 2 within the Division of Health Care Financing and Policy (DHCFP) Long Term Services and Supports unit, in Carson City NV. This position is responsible for overseeing and coordinating activities associated with Nevada Medicaid's Transportation program, which includes emergency and non-emergency medical transportation (NEMT) services.
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Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange.
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Master's degree in public health, healthcare administration, health policy, or a related field. Subject matter expertise with the programs and initiatives of the Centers for Medicare & Medicaid Services (CMS) is preferred.
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Medicaid eligibility is fundamental to the overall Medicaid program, and mastery of eligibility policy and procedure may provide a path for career growth in the health insurance field.
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Award Winning Health Care: We take our work seriously and are proud to be the only hospital in northwest Iowa and southwest Minnesota to receive 5 Stars by the Centers for Medicare and Medicaid Services' CMS Hospital Compare program.
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Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast. Position SummaryThe Phlebotomist Accurately and efficiently performs specimen collections and testing as defined by laboratory policy and procedure manuals.
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Formulates a clear and concise clinically based or administrative argument to denial rationales supported by clinical criteria, including but not limited to, CMS, Florida Medicaid, CFR, Health Plan, InterQual (IQ), Milliman Care Guidelines (MCG), and UpToDate.
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Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.
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Demonstrate the ability to assess, plan, implement and evaluate age appropriate nursing care per ORCH policy/procedure and by meeting regulatory expectations from the Joint Commission and Center for Medicare/Medicaid.
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In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
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About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
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Education/Skills/Experience: The successful candidate will possess the following education/skills/experience:High School Diploma or equivalentWorking knowledge of Medicare and Medicaid regulations, billing, charges and collectionsAbility to multi-task in a fast paced work environmentProficient with Microsoft Office software – Word, Excel, OutlookTrack record of exceptional customer serviceFront Desk experience in a health care setting preferred.
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5 or more years’ experience in Medicaid, State legislative or executive branch staffer or equivalent experience in Medicaid policy, trade group, law firm, consulting firm, or policy organization.
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health policy medicaid jobs
FEATURED BLOG POSTS
Virtual Reality Job Interviews
With the advent of desktop computers, the arduous task of scouring through weekly job classifieds became a thing of the past. The mid-1990s brought about a new era where job seekers could easily search and apply for jobs online. The introduction of AOL's Instant Messaging feature provided an even faster means for employers and candidates to communicate and schedule interviews. As smartphones became more pervasive in the early 2000s, hiring managers increasingly used phone calls for screening and interviewing candidates. Despite this trend, over 80% of interviews still took place in person.
A Potential TikTok Ban?!
As you may already know, there has been a lot of talk lately about the possibility of a TikTok ban. While this has not yet come to fruition, it's important to consider the implications this could have for businesses and recruiters who rely on TikTok as a platform to market their brand, recruit new talent, and connect with their audience.
The Effects of Workplace Racism and Sexism
One day it's a covert statement to a mother returning to work after maternity leave. Another day it's a lingering gaze at an employee enjoying a culturally rich meal. These microaggressions (or sometimes macroaggressions) can take an employee from a confident, high-performer to one that feels insecure being themselves at work. Your employees engage with people with different ideas and feel most comfortable and valued when they can work without losing their cultural, racial, and gender identity. While most employers know this, why have workplace racism and sexism often been neglected?
When Rage Applying Strikes: How to Identify Unserious Candidates
As the job market remains highly competitive, we have seen a surge in "rage applying." This is when candidates apply to multiple jobs, often without considering whether they are truly interested in the role. Rage applying goes hand-in-hand with quiet quitting. Often, employees want to entertain the thoughts and feelings of leaving their job, but they aren't necessarily serious about leaving yet. Meanwhile, other employees engaging in this trend are actually trying to find a better role. As a recruiter, it can be hard to identify who are the real applicants in a sea full of quiet quitters, but understanding rage applying and identifying red flags will certainly help.
How to Increase Job Ad Exposure
In today's competitive job market, writing quality job ads is critical for attracting top talent to your organization. While networking and candidate referrals are prime real estate for finding qualified candidates, nothing beats the tried-and-true method of writing an extraordinary job ad. But while writing a great job ad is the first step, what's more important is increasing visibility. You could have the most detailed, well-written ad on the internet, but if no one sees it, then you are wasting time (and potentially money!). Employers often believe that job boards are the root of the problem, but you can learn how to increase job ad exposure by tweaking a few steps of your recruitment process.
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The job market has shifted significantly in recent years. The accelerated adoption of technology has not only pushed many companies into remote working arrangements but also increased the availability of supporting tools and technologies (i.e., video conferencing and collaboration software).