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Weston , Westwood, Weymouth, Winthrop , Case Manager, Case Management, Housing, Mental Health, Managed Care, Social Services, Social Work, Care Coordinator, Social Worker, Elder, Geriatric Care, Assisted Living, Human Services, LSW, LCSW, Licensed, Medicare, Medicaid, Behavioral Health, Community Health, Long Term Care, Registered Nurse, Nurse, RN, Nursing, Telecommuting, Remote, Telecommuter, TelecommutePowered by JazzHR.
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Ensure that emerging developments in Congress and the federal government’s regulatory community, with a specific focus on federal health care-related activities at the US Department of Health and Human Services, the Center for Medicare and Medicaid Services, the US Department of Labor, the US Department of Treasury and other relevant federal agencies, are crafted in a manner consistent with and support the division’s and the company's integrated business initiatives.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Strong functional knowledge of specialty pharmacy and health insurance and benefits (i.e. Medicare Part D, commercial and Medicaid) with a solid understanding of insurance eligibility, benefit verification, prior authorization processes, reimbursement coverage, appealing insurance denials, application of financial assistance, co-pay support and bridge programs.
$103,563 - $126,577 a yearFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems. 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.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Advises transplant candidates on insurance and funding options including providing information regarding alternate funding and choices of insurance coverage i.e., Medicare and Medicaid eligibility, COBRA, Social Security Disability, retirement plans, etc.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Duties include ensuring that the program complies with all Centers for Medicare and Medicaid Services (CMS) guidelines, State regulations, and ensuring the financial viability/continued growth of the program, managing business relationships with all contracted providers, and managing the state and federal relationships surrounding the aspects of Home Health Care Services.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Ensure seamless coordination towards the drafting and advancement of effective federal legislation and regulations from BCBSMA to Congress and relevant federal agencies and ensure the coordinated flow of relevant legislative and regulatory information to the Vice President, State and Federal Government and Regulatory Affairs, and senior leaders including the Senior Vice President.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Maintains knowledge of NCQA standards and health plan enrollment and credentialing guidelines (including Medicare and Medicaid). Knowledge of Medicare, Medicaid and health plan credentialing, recredentialing and enrollment process; licensure requirements and regulations of various agencies such as the board of Registration in Medicine, American Board of Medical Specialties and Individual Specialty Boards preferred normally acquired through related work experience.
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Conduct Medicare, VA, and Medicaid payment policy research and analysis, develop strategic recommendations. Broad knowledge of Medicare, managed care, third party payers, and Medicaid required; knowledge of Medicare rulemaking process, Durable Medical Equipment benefit category preferred.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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The Lien Specialist role is responsible for file intake and set up of all Medicare, Medicare Advantage Plan, Part D, and Medicaid referrals including a full review, analysis, and dispute of correspondence received from the various recovery contractors.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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The MDS Coordinator / Clinical Reimbursement manages the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure appropriate reimbursement for all services provided within the nursing.
Full-timeExpandApply NowActive JobUpdated 17 days ago - UpvoteDownvoteShare Job
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As an Education and Training Manager at Telligen you will be responsible for developing a comprehensive education and training program for staff, Providers, Health Plans, PACE Organizations, Members, and other stakeholders to support the implementation and ongoing operations for State Medicaid/Medicare Solutions.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Our patients are seniors and persons with disabilities covered under Medicaid or both Medicaid and Medicare. Job Details:This position is responsible for coordinating the oversight of compliance programs of all Medicare First Tier, Downstream and Related Entities (FDRs) and identified vendors to ensure compliance with all state and federal regulations and have effective compliance programs to prevent, detect and re-mediate noncompliance.
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Strong functional knowledge of health insurance and benefits (i.e. Medicare Part D, commercial and Medicaid) with a solid understanding of insurance eligibility, benefit verification, prior authorization processes, reimbursement coverage, appealing insurance denials, application of financial assistance, co-pay support and bridge programs.
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medicare medicaid jobs in Boston, MA
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