Author: MM_ADMIN

Clipped from: https://jobs.ksnt.com/jobs/billing-collections-specialist-medicaid-atlanta-georgia/757423757-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Apply for this job now Location Atlanta, Georgia Job Type Permanent Posted 28 Oct 2022

Position Description
Bills and collects on hospital Medicaid/CMO accounts in a timely and accurate manner.

Position Requirements
Required:
One (1) year experience in hospital Medicaid/CMO billing or collections, OR Associate’s Degree in Business.
Good verbal communication skills, and basic typing ability.

Preferred:
B.S. degree in Business or Accounting.
Two (2) years experience in hospital Medicaid/CMO billing or collections.
Prior hospital business office collections.
Demonstrated knowledge of hospital electronic billing systems.

 

License/Certification Requirements: No

 

Work Hours: 8a-4:30p

 

Weekend Requirements: No

 

On-Call Requirements: No

 

Apply for this job now

Details

• Job Reference: 757423757-2
  
• Date Posted: 28 October 2022
  
• Recruiter: Northside Hospital
  
• Location: Atlanta, Georgia
  
• Salary: On Application
  
• Sector: Accounting
  
• Job Type: Permanent
  

Clipped from: https://www.glassdoor.com/job-listing/medicaid-waiver-case-manager-middle-alabama-area-agency-on-aging-JV_IC1127424_KO0,28_KE29,64.htm?jl=1008165764793&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Job Title: Case Manager for the Medicaid Waiver Service Program – Elderly and Disabled Waiver.

Job Location: Office in Alabaster – Agency serves Central Region (Blount, Chilton, Shelby, St Clair, and Walker counties)

Case load Areas– Ccaseloads available – Walker and Blount County

Job Status: Full-time – Exempt

Summary: Case Managers serve Medicaid eligible clients who would otherwise require nursing home care and are at risk for nursing home placement. The Medicaid Waiver Service (MWS) program aims for clients to remain in their own home and delay/avoid institutionalization by locating, coordinating, and monitoring services. *NCQA accredited program.

Essential Duties and Responsibilities include the following:

• Conduct Case Management services for clients on the MWS Elderly and Disable Waiver in the FamCare software system through monthly home visits.
  
• Caseload is up to 40 elderly, disabled clients, and or disabled children using the medical social work model. Hiring Case Managers for caseloads in the Walker and Blount Counties.
  
• Monitor the service delivery of the Care Plan and complete Assessments.
  
• Update data entry pertaining to medication, doctor appointments, durable medical equipment, and diagnosis data in real-time during home visits.
  
• Assist clients to develop Smart Goals.
  

 
 

• Completes transitions tracking, documents medication, doctor changes/appointments, and tracks critical incidents.
  
• Write effective documentation narratives.
  

Education and Experience:

Bachelor’s Degree in social work, psychology, or related field. Experience in social work, especially the geriatric population is desired.

Relevant Knowledge:

Possess experience in MS Office, ability to learn new software, and general office procedures.

Ability to communicate clearly and effectively, both verbally and in writing.

Time management and organizational skills.

Additional Requirements:

· Possess a valid driver’s license.

· Must maintain automobile 100/300/100 liability insurance; TB Skin Testing upon hire.

Benefits: State of Alabama Retirement; State of Alabama Local Government Health Insurance (BCBS); and other benefits.

How to Apply: Email cover letter, resume, three references, and salary requirements.

Work Remotely

• Possible with Supervisor’s clearance.
  

Job Type: Full-time

Pay: From $19.23 per hour

Benefits:

• Dental insurance
  
• Flexible schedule
  
• Health insurance
  
• Retirement plan
  

Schedule:

• Monday to Friday
  

COVID-19 considerations:
M4A follows CDC guidelines.

Education:

• Bachelor’s (Preferred)
  

Work Location: One location

Clipped from: https://www.adzuna.com/details/3632946881?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Location: Company:

 
 

Maximus seeks an implementation director with Medicaid experience overseeing the implementation and integration of government systems and operational projects. The ideal candidate has experience in transformation projects, replacing legacy systems with modular, integrated systems and a background in Medicaid or healthcare systems. However, other system transformation and integration experience will be considered.

 
 

Primary Responsibilities:

 
 

• Manage Maximus departments, in a matrix environment, to successfully implement new contracts
  
• Create and maintain project schedules
  
• Present status reports to internal and external clients
  
• Write and review project deliverables
  
• Participate in proposal development process
  
• Lead requirements gathering and analysis sessions
  
• Manage all client contact throughout the implementation of a complex project, including systems and operations projects
  
• Track all implementation activities and artifacts. Lead and participate in requirement and process analysis sessions and interviews
  
• Create MS Project schedules to align with required timeline and scope
  
• Create and review project deliverables
  
• Maintain project forecasts and budgets
  
• Collaborate with various functional and technical teams (Maximus and external partners) to ensure timeline, complete, and accurate implementations
  
• Contribute to corporate repository of project standards
  
• Contribute to proposal writing
  

Clipped from: https://www.glassdoor.com/job-listing/pharmacist-centers-for-medicare-and-medicaid-services-JV_IC1129923_KO0,10_KE11,53.htm?jl=1008236904669&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Requirements

Conditions of Employment

• You must be a U.S. Citizen or National to apply for this position.
  
• You will be subject to a background and suitability investigation.
  
• This is a remote position; however, the position reports to a CMS Office on a periodic basis. Requirements to report to the office will vary and can be discussed at the time of interview.
  

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT.


Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration.


BASIC REQUIREMENTS:


The following lists the basic requirements for the position of Pharmacist. Current federal employees assigned to positions in this occupational series, GS-0660 as of September 2017 or before will be considered to have met the basic requirements for the position occupied. However, they must meet all other requirements for this position as listed below.


Education: A doctoral degree in Pharmacy that is recognized by the Accreditation Council for Pharmacy Education (external link) (ACPE) or an accrediting body recognized by the U.S. Department of Education (external link) at the time the degree was obtained.


Licensure: Applicants must be licensed to practice pharmacy in a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Proof of license/registration MUST be submitted at time of application to verify possession of the license/registration listed above. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating. Please see the “Required Documents” section below for more information.


Medical Requirement: You must be able to distinguish basic colors.


In addition to the licensure and requirements, listed above, you must demonstrate in your resume a minimum of one year of professional pharmacy experience equivalent to at least the GS-12 grade level. Applicant’s qualifications and background must demonstrate the knowledge, skills, abilities, and competencies necessary to perform the work of the position. Pharmacy work requires knowledge of the use, clinical effects, and composition of medications, including their chemical, biological, and physical properties. Qualifying professional pharmacy experience may involve, but is not limited to:

• Dispensing medications prescribed by physicians and other health practitioners and providing information to health practitioners and patients about proper usage of medications and side effects;
  
• Performing drug policy analysis and conducting research on pharmaceutical industry pricing trends in order to give authoritative advice on issues such as updating Medicare drug benefit designs, cost-effectiveness, cost minimization, quality life-years, overall drug therapy costs, and budget forecasting.
  
• Leading work on interpreting and analyzing pharmacy administrative claims and plan-reported data concerning drug coverage, pharmacy services, and drug utilization patterns.
  
• Evaluating medication use patterns and outcomes for patients in hospitals or managed care organizations;
  
• Performing administrative, consultative, or staff advisory work for a medical facility’s pharmacy program;
  
• Planning, monitoring, and evaluating medication programs or regimens;
  
• Establishing medication-handling procedures for the storage and preservation of medications;
  
• Researching medical literature and/or clinical medication information to provide accurate responses to inquiries; and/or
  
• Maintaining all medication records required by law.
  

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

Education

Education Requirement: You must have the following educational requirements:


A doctoral degree in Pharmacy that is recognized by the Accreditation Council for Pharmacy Education (ACPE) or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained.


You are strongly encouraged to submit a copy of your transcripts at the time of application. Unofficial transcripts will be accepted at the time of application. Official transcripts will be required from all selectees prior to receiving an official offer.


Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/11706065

Additional information

Bargaining Unit Position: Yes – American Federation of Government Employees, Local 1923

Tour of Duty: Flexible

Recruitment/Relocation Incentive: Not Authorized

Financial Disclosure: May be required, based on the duties of the position.


To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce Executive Order 14043 Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a federal job announcement includes the requirement to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply. Positions with vaccination requirements under authority(ies) separate and distinct from Executive Order 14043 will be clearly identified. HHS may continue to require documentation of proof of vaccination to ensure compliance with those policies. Health and safety protocols remain in effect, in accordance with CDC guidance and the Safer Federal Workforce Task force. Consistent with current guidance, workplace safety protocols will no longer vary based on vaccination status or otherwise depend on the availability of vaccination information. Therefore, to the extent a job announcement states that HHS may request information regarding the vaccination status of selected applicants for the purposes of implementing workplace safety protocols, this statement does not currently apply.


Remote-Out Positions at CMS: This is a remote position; however, the position reports to a CMS Office on a periodic basis (e.g. 1-2 times per year). Requirements to report to the office will vary and can be discussed at the time of interview. As such, your pay will be based on your home address. For more information on locality and pay scales, please click here. Your worksite must be within the United States and you must adhere to all regulations and policies regarding remote work at CMS and in the federal government, including the signing of a remote work agreement.


The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy. Click here for a detailed description of the required supporting documents. A well-qualified applicant is one whose knowledge, skills and abilities clearly exceed the minimum qualification requirements of the position. Additional information about ICTAP and CTAP eligibility is on OPM’s Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp.

 
 

• Benefits
  

A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

Clipped from: https://www.glassdoor.com/job-listing/fp-and-a-analyst-medicaid-fully-remote-cvs-health-JV_KO0,38_KE39,49.htm?jl=1008236750851&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Exciting opportunity to join a dynamic Finance team for a Fortune 5 company!


Join the Medicaid Segment Financial Planning and Analysis team and help support our Expense Team deliverables for forecast / Budget cycles. This role will support our new Expense team with SG&A analyses, reporting / tracking, and enhancing data utilization for leadership teams’ decision making. The successful candidate in this position will support all SG&A management initiatives including helping with data gathering, analysis, and supplemental / ad hoc requests for additional insights needed. They will also develop new and innovative ways to analyze data and trends within Medicaid to better assist our leadership team’s decision-making abilities. In addition, the successful candidate will need to understand how all of Medicaid’s SG&A components impact not only the Medicaid segment, but the overall HCB segment/CVS Health forecasts as well.


Pay Range
The typical pay range for this role is:
Minimum: 40,560
Maximum: 81,100


Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.


Required Qualifications

• 2+ years of professional work experience including internship(s); experience with financial analysis, budgeting, forecasting, close reporting, and month-end variance analysis.
  

 
 

• 1+ years of Microsoft Excel experience required. Experience using functions such as PivotTables, VLOOKUP, Filters, Sum if(s), and Index (Match).
  

 
 

• 1+ years of experience multi-tasking and working under tight deadlines.
  

Preferred Qualifications

• Experience analyzing P&L’s & Financial trends.
  

 
 

• System input experience using Hyperion or a related forecasting tool
  

 
 

• Foster strong relationships with other teams and be able to adapt to change.
  

 
 

• Ability to work independently and experience as a self-starter.
  

 
 

• Effective verbal and written communication skills.
  

 
 

• Strong attention to detail and analytical skills.
  

Education
Bachelor’s Degree or equivalent work experience required. Preferably in Finance, Business, Accounting, or related field.


Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Clipped from: https://jobs.mystateline.com/jobs/medicaid-enrollment-team-lead-phoenix-arizona/757420368-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Medicaid Enrollment Team Lead

 
 

Responsibilities may include but are not limited to:

 
 

• Process daily enrollee invoices and premium reconciliation for Marketplace members.
  
• Perform month-end invoicing and accuracy audits.
  
• Administer claims payments, maintain claim records, and provide counsel to claimants regarding coverage amount and benefit interpretation.
  
• Monitor and control backlog and workflow of claims and ensure that claims are settled in a timely fashion and in accordance with cost control standards.
  
• Assist in resolution of escalated premium payment issues with Appeals and Grievances team.
  
• Guide and collaborate with Enrollment team to resolve eligibility issues affecting premium billing.
  
• Ensure the accurate billing and posting of payments on accounts.
  
• Complete adjustments for bad debt accounts and is responsible for timely correction of posting errors.
  
• Verify, document and investigate the presence of health care coverage for Medicaid recipients and their families.
  
• Assist in the identification of members that may qualify for the HIPP/Premium Assistance program.
  
• Complete maintenance of active cases during open enrollment and premium review for check processing to assist with maintaining the revenue and program growth.
  
• Partner with enrollment teams and offer guidance where premiums are directly impacted by enrollment discrepancies.
  

 
 

Location for this position is Phoenix, AZ.

 
 

Qualifications

Basic

 
 

• High School Diploma or GED Equivalent
  
• At least 4 years of relevant work experience
  

 
 

Preferred

 
 

• Knowledge of basic Medicaid/Medicare billing rules, regulations, and deadline
  
• Must have excellent time management and organizational skills.
  
• Strong team-oriented individual.
  
• Excellent communication with all levels of team.
  
• Must have strong knowledge and experience in MS office products, minimally Outlook, Word and Excel.
  
• Access or SQL experience is a plus.
  

 
 

Note: Applicants for employment in the U.S. must possess work authorization which does not require sponsorship by the employer for a visa (H1B or otherwise).

The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email or face to face.

 
 

About Us

Infosys BPM Limited, a wholly owned subsidiary of Infosys Limited (NYSE: INFY), provides end-to-end transformative business process management (BPM) services for its clients across the globe. The company’s integrated IT and BPM solutions approach enables it to unlock business value across industries and service lines, and address business challenges for its clients. Utilizing innovative business excellence frameworks, ongoing productivity improvements, process reengineering, automation, and cutting-edge technology platforms, Infosys BPM enables its clients to achieve their cost reduction objectives, improve process efficiencies, enhance effectiveness, and deliver superior customer experience.

Infosys BPM has 35 delivery centers in 14 countries spread across 5 continents, with 53,515 employees from 125 nationalities, as of June, 2022.

The company has been consistently ranked among the leading BPM companies globally and has received over 60 awards and recognitions in the last 5 years, from key industry bodies and associations like the Outsourcing Center, SSON, and GSA, among others. Infosys BPM also has very robust people practices, as substantiated by the various HR-specific awards it has won over the years. The company has consistently been ranked among the top employers of choice, on the basis of its industry leading HR best practices. The company’s senior leaders contribute widely to industry forums as BPM strategists

Clipped from: https://www.adzuna.com/details/3632650783?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Location: Company: Employment type: Hours:

 
 

Description


Location: Remote in Ohio, preferably near Columbus or Mason, OH

Build the Possibilities. Make an extraordinary impact.

Responsible for driving the development, coordination, communication, and implementation of a strategic clinical quality management and improvement program within assigned health plan.

How you will make an impact:

• Develop and manage improvement projects, including ensuring impact at a population level and identifying and prioritizing initiatives to align with the Quality Strategy.
  
• Oversee improvement teams and coordinate QI training for staff.
  
• Reinforce the application of QI tools and methods within improvement projects and initiatives.
  
• Ensure that learning from all improvement projects and initiatives are shared with Ohio Department of Medicaid and ODM’s contracted managed care entities.
  
• Directs and provides leadership for implementing, monitoring and evaluating the Quality Management Program for the health plan.
  
• Promotes understanding, communication, and coordination of the quality management program.
  
• Directs and provides leadership for compliance with National Committee for Quality Assurance (NCQA) standards.
  
• Provides leadership for the interpretation of results and development of improvement action plans arising from provider and member satisfaction surveys.
  
• Serves as a resource for the design and evaluation of process improvement plans/quality improvement plans and ensures they meet Continuous Quality Improvement (CQI) methodology and state contractual requirements.
  
• Collaborates with other leaders in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set (HEDIS) improvement action plans, year round medical record review, and over read processes.
  
• Monitors and reports quality measures per state, Centers for Medicare and Medicaid Services (CMS), and accrediting requirements.
  
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
  

Minimum Requirements:

• Requires a BA/BS in a health or business related field; 8 years of experience in a healthcare environment, including prior management experience; or any combination of education and experience, which would provide an equivalent background.
  
• Must be an Ohio-licensed registered nurse, physician, or physician’s assistant, or be certified as a Certified Professional in Health Care Quality by the National Association for Healthcare Quality (NAHQ), Certified QI Associate by the American Society for Quality, and/or Certified in Health Care Quality and Management (CHCQM) by the American Board of Quality Assurance and Utilization Review Providers (prior to employment or within six months of the date of hire).
  

Preferred Skills, Capabilities and Experiences:

• Experience in quality management and quality improvement strongly preferred.
  

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.


Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.


We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.elevancehealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.