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Maintain continuous communication with the resident, responsible party, outside attorney, facility attorney or outside provider if the application was completed with someone other than the Medicaid Coordinator, in conjunction with the Business Office Manager.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Makes recommendations to the Eligibility and Client Services Section, Eligibility and Client Services Section Administrator, the Senior Eligibility Manager, Vendor Contract Managers, and the Benefits Coordination Manager as needed, to confirm Medicaid eligibility determinations are meeting the goals of the program.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Experience working with managed care claims, third-party liability, Medicaid waiver programs, and provider enrollment; Knowledge and expertise in managed care claims, third-party liability, Medicaid waiver programs, and/or provider enrollment.
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PSU staff will also coordinate with various internal HHSC departments such as Managed Care Compliance and Operations (MCCO) and Medicaid for the Elderly and People with Disabilities (MEPD). Perform interest list activities such as confirming accurate contact information, mail enrollment packets, determine appropriate MCO enrollment and verify applicants desire to enroll in a Medicaid waiver program.
Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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NC Department of Health and Human Services (DHHS) Information Technology Division (ITD) seeks a Quality Assurance (QA) Test Lead for the Medicaid Enterprise System (MES) Program. The QA Test Lead will be responsible for overseeing and managing the end-to-end testing of one or more modules in a mult million-dollar Medicaid Enterprise System (MES)/Medicaid Modular Information System (MIMS) project for the State of North Carolina.
ExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Bachelor’s degree with 12+ years US State-level health policy experience or 10 years of combined State health policy and Medicaid policy experience OR Masters degree in field with 8+ years of related work experience OR Doctoral degree in field with 5+ years of related work experience.
$150,000 - $220,000 a yearFull-timeExpandApply NowActive JobUpdated 17 days ago - UpvoteDownvoteShare Job
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The Assistant Business Office Manager (ABOM) provides administrative support to the Business Office Manager and the processes of billing facility charges to the appropriate payor, collecting outstanding Accounts Receivables, and overseeing Medicaid Pending cases, ULTCs, consolidated billing, Medicaid re-determinations and appeals in accordance with Nexion Corporate policy and applicable federal, state, and local regulations.
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Senior Whole Health by Molina is a Managed Long-Term Care (MLTC), and Medicaid Advantage (MAP) plan. Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.
$14.76 - $31.97 an hourFull-timeRemoteExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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This posting is for an Assistant Attorney General in the Texas Medicaid Fraud Control Unit, which will be cross-designated as a SAUSA, and serve as a Trial Attorney/Prosecutor for the United States Attorney's Office (USAO) - Southern District and work with the FBI, HHS-OIG, and other agency partners in order to identify, investigate, and prosecute significant health care fraud (HCF) cases.
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Work on issues related to Medicare coverage determinations, Medicaid coverage and preferred drug list determinations, FDA drug development and safety policies, agency guidance policies related to patient engagement and diversity equity and inclusion (DEI) impacting health access, clinical trials, and research opportunities.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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This is a field-based position conducting UAS initial, reassessment, and home abstract visits for our TBI and NHTD Medicaid waiver programs. The Registered Nurse will be responsible for the completion of UAS assessments, and all other required clinical documentation related to the TBI and NHTD Medicaid waiver programs.
Full-timeExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
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Knowledge of CMS claims data, including Medicare, Medicaid, and Marketplace, in the IDR or CCW environment with Fee-for-Service (FFS), Medicare Advantage encounter data, Medicaid data in the Transformed Medicaid Statistical Information System (T-MSIS), or Prescription Drug Event (PDE) data.
$73,100 - $166,000 a yearFull-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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The Product Integration Specialist goes hand in hand with the Product Manager and Core Business team and represents DHHS business functions within NC Medicaid and functions within the Product Management Space.
ExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Medicaid managed care experience working with LTSS program population. Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.
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medicaid job Title: field reimbursement manager Company: Amerisourcebergen Corporate
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