- Alternate Solutions Health Network LLC (Columbus, OH)
- …patients like they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention ... (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers. Based on this regulation, all of our employees must be fully vaccinated or… more
- U of C NORC (Bethesda, MD)
- …a range of policy issues facing public health insurance programs such as Medicaid , Medicare, and Marketplace coverage.Our subject matter experts employ a variety of ... analysis required.Experience researching public health insurance programs such as Medicaid and Medicare.Understanding of routine sampling procedures and working… more
- U of C NORC (Bethesda, MD)
- …knowledge of Traditional Medicare, Medicare Parts C & D, and Medicaid policy including ongoing value-based care initiatives.Monitor and oversee the financial ... relevant administrative data sets such as Medicare Advantage, Medicare Part D, Medicaid data as well as private-sector dataA strong foundation in quantitative and/or… more
- Lundbeck (New York, NY)
- …and external partners and effectively addresses payer access issues (Medicare, Medicaid , Commercial) using Lundbeck resources. Local Market & Therapeutic Area ... Expertise - Gather and validate key trends and dynamics in the market, map account linkages, and apply comprehensive therapeutic knowledge to uncover and prioritize unique opportunities. Demonstrates a clear and detailed understanding of the disease state and… more
- Novo Nordisk Inc. (Wheaton, IL)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify business opportunities… more
- Lundbeck (Bronx, NY)
- …and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - Ability ... to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.REQUIRED EDUCATION, EXPERIENCE and… more
- Lundbeck (Rockford, IL)
- …Medicare payer landscape in addition to other payer channels including Medicaid and Commercial. Pharmaceutical Environment/Compliance - Ability to apply knowledge of ... pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.REQUIRED EDUCATION, EXPERIENCE and SKILLS: Bachelor of Arts… more
- Merck & Co. (North Wales, PA)
- …partners and focus on customer segments (eg health plans, Medicare, Medicaid , federal, pharmacy, hospital, Group Purchasing Organization s, etc.). Primary ... Responsibilities: Work closely with our Company's internal functions (promotions, communications, medical affairs, brand marketing, etc.) and external agency partners to develop customer specific strategies and execute as appropriate to achieve access for… more
- Daiichi Sankyo, Inc. (Basking Ridge, NJ)
- …association, think tank, or pharmaceutical company required- Expertise in Medicare, Medicaid , 340B, and/or commercial insurance market required- Strong knowledge of ... federal legislative and rulemaking processes; experience researching and analyzing complex public policy issues required- Expertise in oncology and physician-administered medicines preferred Travel Ability to travel up to 20% Travel for business meetings as… more
- Tris Pharma (Monmouth Junction, NJ)
- …adjustments and other financial analysis. Perform analysis of sales, returns, Medicaid data, Managed Care data, chargebacks, wholesaler inventories and other data ... to ensure accuracy and appropriate reserves.Prepare and post month end accrual entries.Collaborates with commercial operations and other key stake holders on various aspects of Brand Revenue reporting (eg, weekly & monthly sales reports)Prepare monthly and… more
- US Tech Solutions, Inc. (Linthicum Heights, MD)
- Duration: 03 Months Job Summary: looking for a Medicaid Eligibility Retention Specialist to work with and assist members to retain or renew their Medicaid ... the disenrollment of members due to loss of their Maryland Medicaid eligibility. Responsibilities: Understand, and assure compliance to and adherence with,… more
- Accounting Now (Pinellas Park, FL)
- …documenting related account activities, posting adjustments and collections of Medicare, Medicaid , Medicaid Managed Care, and commercial insurance payers. The ... specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment… more
- HHS Technology Group, Inc. (Atlanta, GA)
- …for Call center activities and support; focus is on healthcare providers Medicaid enrollment activity and on processing new applications and re-validation procedures ... are hard to understand. Responsibilities: Process large amounts of Medicaid provider enrollment applications. Assess provider's requirements, clarify information,… more
- HHS Technology Group, Inc. (Atlanta, GA)
- …quality, change management and project financials. 4+ years of Medicaid , MMIS, Decision Support Systems (DSS), eligibility/enrollment systems, claims process ... ALM tools, Jira, CA Rally. 2+ years of experience with Medicaid Enterprise Certification Toolkit (MECT), Outcomes Based Certification, Streamlined Modular… more
- Northeast Georgia Health System, Inc (Demorest, GA)
- …transmission to verify receipt of claims by FI. Verifies eligibility of Medicaid recipients and Medicare beneficiaries by utilizing electronic data system when proof ... as indicated. Communicates with claims personnel with Medicare and Medicaid fiscal intermediaries and commercial payors concerning unclear claims information… more
- HHS Technology Group, Inc. (Atlanta, GA)
- …support, including reporting and optimizing metrics; focus is on healthcare providers Medicaid enrollment activities. What you will do The Provider Analyst Lead will ... are hard to understand. Responsibilities: Process large amounts of Medicaid enrollment updates and applications. Assess provider's requirements, clarify information,… more
- Rose International (Fort Wayne, IN)
- …Written Communication Nice To Have Skills/Attributes: Call Center, Case Management, Medicaid Systems Job Description **Only those lawfully authorized to work in ... for receiving high volume, often back-to-back, inbound calls about Medicaid , Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for… more
- US Tech Solutions, Inc. (Hamilton Township, NJ)
- …can resolve customer issues in the areas of claims manually as required by Medicaid rules and system limitations as defined by policy and departmental procedures and ... payment of claims. * Resolves pending claims based on Medicaid rules and regulation established for final processing. *...by providers. * Prices claims manually as required by Medicaid rules and system limitations as defined by policy… more
- Creative Financial Staffing (Auburn, IN)
- …detail-oriented and experienced Billing Specialist with extensive knowledge of Medicare and Medicaid billing procedures to join our team. As a Billing Specialist, ... the Medical Billing Specialist: Prepare and submit claims to Medicare and Medicaid in compliance with their billing guidelines and regulations. Verify patient… more
- Volunteers of America Mid-States (Louisville, KY)
- …to communications, social casework, and billing requirements with KY Medicaid . Responsible for the overall clinical services to men/women/children/families that ... 4. Maintain billing requirements along with understanding of BHSO, AODE and KY Medicaid Regulations 5. Manage caseload and client needs 6. To develop and monitor… more
