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Assist in the preparation and drafting of testimony, regulatory comments, and position statements sent to legislative and regulatory bodies and other interested parties concerning legislation, policies, published reports, regulations, and statutes governing Medicaid, long-term services and supports (LTSS), and other waiver programs.
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You will serve as Health Facility Surveyor with the Health Care Surveillance Branch, Healthcare Licensing and Surveys, Wyoming Department of Health, conducting surveys and investigating complaints statewide according to Wyoming State Statutes agreement with the federal Centers for Medicare and Medicaid Services (CMS.
$32.52 - $36.13 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Demonstrated understanding and knowledge of Medicaid, CMS, SMC/OBC, and MES. Deep Medicaid experience is critical, as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined modular certification (SMC) and outcomes-based certification (OBC.
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Makes themselves available to answer questions from the Department, or their designee, the Guardian ad-Litem, and the Medicaid health plan that is financially responsible for the child’s care in treatment.
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This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits.
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Knowledgeable in in value-based care, medical/clinical services, managed care principles; possess and actively maintain a contemporary knowledge of the provider community and their functional environment as well as the overall health care landscape; working knowledge of healthcare financing models such as Medicare, Medicaid, SNP, PACE.
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Experience in health/human services and knowledge of WY Medicaid preferred. Providing education, assistance, and eligibility services to Wyoming Medicaid customers. Experience in health/human services and knowledge of WY Medicaid preferred.
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Knowledge of legislative/oversight bodies (e.g., URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQNational Committee for Quality Assurance, and ERISEmployee Retirement Income Security Act of 1974.
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In this pivotal role, you'll collaborate closely with medical providers, ensuring seamless Medicaid billing and claims submission. Your primary focus will be providing essential support for Medicaid billing requirements and claims submission, thereby ensuring quality care for Medicaid recipients.
$55,000 - $64,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Extensive experience in healthcare contracting, with a critical understanding of PBMs, National Health Plans, Medicare Part D/B, GPOs, VA/DoD, Medicaid, and the evolving market landscape. Minimum of 12 years of pharmaceutical industry experience, with significant expertise in at least two of the following areas: Channel Strategy, Finance, Pharmacy, Pricing, Trade, or Market Access.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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IT Solutions, Staffing and Consulting, Medicaid/MMIS Integration and Implementation, HL7 Integration and Implementation, Health Data Analysis and Analytics, Data Conversions, Data Warehouse Design, Development and Implementations, and Project Management.
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