PR · On-site
Demonstrates sound knowledge of reimbursement and billing practices for Medicare, Medicaid, managed care, charity care and other third-party payers * Demonstrates cultural sensitivity * Maintains ...
PR · On-site
Demonstrates sound knowledge of reimbursement and billing practices for Medicare, Medicaid, managed care, charity care and other third-party payers * Demonstrates cultural sensitivity * Maintains ...
Required Qualifications: * 1 years of experience in an office environment managing time-sensitive deadlines * 1 years of direct experience with Medicaid and Medicare provider enrollment * Proven ...
Required Qualifications: * 1 years of experience in an office environment managing time-sensitive deadlines * 1 years of direct experience with Medicaid and Medicare provider enrollment * Proven ...
... management, or a related field preferred. • Familiarity with Puerto Rico healthcare systems, Medicaid, or government agencies is a plus. • Strong communication and organizational skills. • ...
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... management, or a related field preferred. • Familiarity with Puerto Rico healthcare systems, Medicaid, or government agencies is a plus. • Strong communication and organizational skills. • ...
General Accountant
San Juan, PR · On-site
... CMS/Medicaid/Medicare billing regulations. * Analyze financial performance data and deliver actionable insights and reports to senior management. * Maintain and improve internal controls and ...
General Accountant
San Juan, PR · On-site
... CMS/Medicaid/Medicare billing regulations. * Analyze financial performance data and deliver actionable insights and reports to senior management. * Maintain and improve internal controls and ...
$17.25 - $20.75/hr
... Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties are assigned by the manager and/or supervisor. Requirements * Pharmacy ...
$17.25 - $20.75/hr
... Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties are assigned by the manager and/or supervisor. Requirements * Pharmacy ...
Pharmacy Technician
$17.25 - $20.75/hr
... Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties are assigned by the manager and/or supervisor. Requirements * Pharmacy ...
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Pharmacy Technician
$17.25 - $20.75/hr
... Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties are assigned by the manager and/or supervisor. Requirements * Pharmacy ...
$70K - $85K/yr
Knowledge of Medicare, Medi-cal and Medicaid programs and benefits. * PCC Knowledge preferred. * Certificate as a certified Case Manager (CCM) a plus. * Must maintain all required continuing ...
$70K - $85K/yr
Knowledge of Medicare, Medi-cal and Medicaid programs and benefits. * PCC Knowledge preferred. * Certificate as a certified Case Manager (CCM) a plus. * Must maintain all required continuing ...
Pharmacy Call Center Specialist- Temp
San Juan, PR · On-site
$80K - $81K/yr
Ensure Medicare & Medicaid Services (CMS) Compliance or other regulating entities related to ... Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries ...
Pharmacy Call Center Specialist- Temp
San Juan, PR · On-site
$80K - $81K/yr
Ensure Medicare & Medicaid Services (CMS) Compliance or other regulating entities related to ... Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries ...
Pharmacy Call Center Specialist- Temp
San Juan, PR · Hybrid
$80K - $81K/yr
Ensure Medicare & Medicaid Services (CMS) Compliance or other regulating entities related to ... Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries ...
Pharmacy Call Center Specialist- Temp
San Juan, PR · Hybrid
$80K - $81K/yr
Ensure Medicare & Medicaid Services (CMS) Compliance or other regulating entities related to ... Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries ...
PR · On-site
Cumple con todas las guías establecidas por los Centros de Medicare y Medicaid (CMS), NCQA, URAC y otras agencias regulatorias, así como HIPAA cuando corresponda; obtiene la educación profesional ...
New
Quick apply
PR · On-site
Cumple con todas las guías establecidas por los Centros de Medicare y Medicaid (CMS), NCQA, URAC y otras agencias regulatorias, así como HIPAA cuando corresponda; obtiene la educación profesional ...
New
PR · On-site
Cumple con todas las guías establecidas por los Centros de Medicare y Medicaid (CMS), NCQA, URAC y otras agencias regulatorias, así como HIPAA cuando corresponda; obtiene la educación profesional ...
New
Quick apply
PR · On-site
Cumple con todas las guías establecidas por los Centros de Medicare y Medicaid (CMS), NCQA, URAC y otras agencias regulatorias, así como HIPAA cuando corresponda; obtiene la educación profesional ...
New
Minimum 2 years of experience in medical records or health information management, preferably in long-term care * Strong knowledge of HIPAA, Medicare/Medicaid documentation standards, and SNF ...
Minimum 2 years of experience in medical records or health information management, preferably in long-term care * Strong knowledge of HIPAA, Medicare/Medicaid documentation standards, and SNF ...
PR · On-site
Basic knowledge of health insurance benefits (Medicare, Medicaid, commercial plans). * Proficiencyin technology tools and computer equipment. * Good keyboard management and data entry skills.
Quick apply
PR · On-site
Basic knowledge of health insurance benefits (Medicare, Medicaid, commercial plans). * Proficiencyin technology tools and computer equipment. * Good keyboard management and data entry skills.
Proven knowledge of Medicaid/Medicare Reimbursement methodologies * Proven working knowledge of the healthcare insurance/managed care industry * Proven working knowledge of medical terminology and ...
Proven knowledge of Medicaid/Medicare Reimbursement methodologies * Proven working knowledge of the healthcare insurance/managed care industry * Proven working knowledge of medical terminology and ...
PR · On-site
... Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties assigned by the manager and/or supervisor. Education : * Bachelor's degree in ...
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PR · On-site
... Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties assigned by the manager and/or supervisor. Education : * Bachelor's degree in ...
PR · On-site
$38K - $51K/yr
Is also responsible for maintaining the Revenue Cycle Manager up-to-date of any situation that ... and Medicaid regulations and receive by payers. * Bill charges to patients when necessary.
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PR · On-site
$38K - $51K/yr
Is also responsible for maintaining the Revenue Cycle Manager up-to-date of any situation that ... and Medicaid regulations and receive by payers. * Bill charges to patients when necessary.
PR · On-site
$14.75 - $18.25/hr
Basic knowledge of health insurance benefits (Medicare, Medicaid, commercial plans). * Proficiency in technology tools and computer equipment. * Good keyboard management and data entry skills.
Quick apply
PR · On-site
$14.75 - $18.25/hr
Basic knowledge of health insurance benefits (Medicare, Medicaid, commercial plans). * Proficiency in technology tools and computer equipment. * Good keyboard management and data entry skills.
Proven knowledge of Medicaid/Medicare Reimbursement methodologies * Proven working knowledge of the healthcare insurance/managed care industry * Proven working knowledge of medical terminology and ...
Proven knowledge of Medicaid/Medicare Reimbursement methodologies * Proven working knowledge of the healthcare insurance/managed care industry * Proven working knowledge of medical terminology and ...
MMM Holdings, LLC is a company that provides Medicare Advantage and Medicaid plans in Puerto Rico ... Non-Management Non-Exempt Workshift: Job Family: MED > Licensed/Certified Allied Health ...
MMM Holdings, LLC is a company that provides Medicare Advantage and Medicaid plans in Puerto Rico ... Non-Management Non-Exempt Workshift: Job Family: MED > Licensed/Certified Allied Health ...
Medicaid Manager information
What are some common challenges a Medicaid Manager faces when coordinating with healthcare providers and state agencies?
Medicaid Managers often encounter challenges when aligning the diverse requirements of healthcare providers with the regulatory expectations of state agencies. Balancing compliance, timely claims processing, and communication between stakeholders can be complex, especially given frequently changing policies and high caseloads. Successful Medicaid Managers stay proactive by fostering strong relationships, staying up-to-date on policy changes, and implementing efficient workflows to minimize errors and delays. This collaborative approach is essential for ensuring quality care delivery while maintaining program integrity.
What does a Medicaid Manager do?
A Medicaid Manager oversees the administration and management of Medicaid programs within a healthcare organization or government agency. They ensure compliance with federal and state regulations, manage budgets, supervise staff, and coordinate services to ensure eligible individuals receive appropriate healthcare benefits. Their role often includes developing policies, monitoring program performance, and collaborating with other departments or agencies to improve service delivery. Medicaid Managers play a critical role in optimizing program efficiency and ensuring quality care for beneficiaries.
What is the difference between Medicaid Manager vs Medicaid Coordinator?
| Aspect | Medicaid Manager | Medicaid Coordinator |
|---|---|---|
| Credentials | Typically requires a bachelor’s degree in healthcare administration, social work, or related field; certifications like Certified Medicaid Planner may be preferred | Often requires similar educational background; certifications are less common but may include Medicaid-specific training |
| Work Environment | Works in healthcare organizations, government agencies, or insurance companies overseeing Medicaid programs | Usually works in healthcare facilities or community organizations assisting with Medicaid enrollment and compliance |
| Responsibilities | Oversees Medicaid program operations, manages staff, ensures compliance, and develops policies | Assists clients with Medicaid applications, explains benefits, and ensures proper documentation |
Medicaid Managers focus on overseeing Medicaid program operations and compliance, while Medicaid Coordinators primarily assist clients with enrollment and benefits. Both roles require similar educational backgrounds but differ in scope and responsibilities.
What are the key skills and qualifications needed to thrive as a Medicaid Manager, and why are they important?
To thrive as a Medicaid Manager, you need expertise in healthcare administration, regulatory compliance, and Medicaid policy, often supported by a bachelor’s or master’s degree in health administration or a related field. Familiarity with Medicaid Management Information Systems (MMIS), data analytics tools, and relevant certifications such as Certified Professional in Healthcare Quality (CPHQ) are vital. Strong leadership, communication, and problem-solving skills help you effectively manage teams and navigate complex healthcare regulations. These skills ensure efficient program administration, regulatory adherence, and improved healthcare outcomes for Medicaid populations.
What are the most commonly searched types of Medicaid jobs in Puerto Rico? The most popular types of Medicaid jobs in Puerto Rico are:
What job categories do people searching Medicaid Manager jobs in Puerto Rico look for? The top searched job categories for Medicaid Manager jobs in Puerto Rico are:
