... Medicaid Specialist leads all Medicaid eligibility activities across the program, including ... care and program revenue integrity WHO WE ARE Franciscan Health is a leading healthcare ...
... Medicaid Specialist leads all Medicaid eligibility activities across the program, including ... care and program revenue integrity WHO WE ARE Franciscan Health is a leading healthcare ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... program integrity initiatives. Essential Functions and Primary Duties * Conduct research in order to determine compliance with relevant Medicaid or other government program regulations * Assist with ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... program integrity initiatives. Essential Functions and Primary Duties * Conduct research in order to determine compliance with relevant Medicaid or other government program regulations * Assist with ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... program integrity initiatives. Essential Functions and Primary Duties * Conduct research in order to determine compliance with relevant Medicaid or other government program regulations * Assist with ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... program integrity initiatives. Essential Functions and Primary Duties * Conduct research in order to determine compliance with relevant Medicaid or other government program regulations * Assist with ...
Responsible for Medicare Advantage and Managed Medicaid program participation rate and incentive ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
Responsible for Medicare Advantage and Managed Medicaid program participation rate and incentive ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
Vice President, Managed Care
Granger, IN · On-site
Responsible for Medicare Advantage and Managed Medicaid program participation rate and incentive ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
Vice President, Managed Care
Granger, IN · On-site
Responsible for Medicare Advantage and Managed Medicaid program participation rate and incentive ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
Residential Program Director
Indianapolis, IN · On-site
$42K - $55K/yr
The ideal candidate will have experience with Medicaid waivers and a passion for enhancing the ... Integrity, Inclusion and the empowerment of individuals rights.
Quick apply
Residential Program Director
Indianapolis, IN · On-site
$42K - $55K/yr
The ideal candidate will have experience with Medicaid waivers and a passion for enhancing the ... Integrity, Inclusion and the empowerment of individuals rights.
Residential Program Director
Indianapolis, IN · On-site
$42K - $55K/yr
The ideal candidate will have experience with Medicaid waivers and a passion for enhancing the ... Integrity, Inclusion and the empowerment of individuals rights.
Quick apply
Residential Program Director
Indianapolis, IN · On-site
$42K - $55K/yr
The ideal candidate will have experience with Medicaid waivers and a passion for enhancing the ... Integrity, Inclusion and the empowerment of individuals rights.
Chief Program Officer (Residential & Day Services)
$120K - $130K/yr
Founded over 70 years ago, we have built a strong reputation for excellence and integrity within ... Familiarity with Medicaid, CARF, or similar regulatory frameworks * Demonstrated experience ...
Chief Program Officer (Residential & Day Services)
$120K - $130K/yr
Founded over 70 years ago, we have built a strong reputation for excellence and integrity within ... Familiarity with Medicaid, CARF, or similar regulatory frameworks * Demonstrated experience ...
Chief Program Officer (Residential & Day Services)
Bristol, IN · On-site
$120K - $130K/yr
Founded over 70 years ago, we have built a strong reputation for excellence and integrity within ... Familiarity with Medicaid, CARF, or similar regulatory frameworks * Demonstrated experience ...
Quick apply
Chief Program Officer (Residential & Day Services)
Bristol, IN · On-site
$120K - $130K/yr
Founded over 70 years ago, we have built a strong reputation for excellence and integrity within ... Familiarity with Medicaid, CARF, or similar regulatory frameworks * Demonstrated experience ...
Payer Quality Consultant, Director
$155K - $410K/yr
You are expected to be a guardian of PwC's reputation, understanding that quality, integrity ... Medicaid program requirements - Leading teams to generate a vision and trust - Building ...
Payer Quality Consultant, Director
$155K - $410K/yr
You are expected to be a guardian of PwC's reputation, understanding that quality, integrity ... Medicaid program requirements - Leading teams to generate a vision and trust - Building ...
Medicare Sales Agent
Indianapolis, IN · On-site
Star Benefit Associates, an Integrity company, was founded with a focus on Small Group products ... Adhere strictly to Centers for Medicare & Medicaid Services (CMS) marketing guidelines (e.g ...
Medicare Sales Agent
Indianapolis, IN · On-site
Star Benefit Associates, an Integrity company, was founded with a focus on Small Group products ... Adhere strictly to Centers for Medicare & Medicaid Services (CMS) marketing guidelines (e.g ...
Staff Analyst
Indianapolis, IN · Hybrid
$59K - $78K/yr
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... integrity of data, performing statistical calculations to determine compliance with Federal ...
Staff Analyst
Indianapolis, IN · Hybrid
$59K - $78K/yr
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... integrity of data, performing statistical calculations to determine compliance with Federal ...
Staff Analyst
Indianapolis, IN · Hybrid
$59K - $78K/yr
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... integrity of data, performing statistical calculations to determine compliance with Federal ...
Staff Analyst
Indianapolis, IN · Hybrid
$59K - $78K/yr
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... integrity of data, performing statistical calculations to determine compliance with Federal ...
Reimbursement Manager
$96K - $145K/yr
... programs. This role is responsible for ensuring all annual Medicare, Medicaid, and state cost ... financial integrity. 3. Strategic Forecasting, Project Management & Administration (20% of Time)
Quick apply
Reimbursement Manager
$96K - $145K/yr
... programs. This role is responsible for ensuring all annual Medicare, Medicaid, and state cost ... financial integrity. 3. Strategic Forecasting, Project Management & Administration (20% of Time)
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
State Eligibility Consultant
Terre Haute, IN · On-site
$37K/yr
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
State Eligibility Consultant
Terre Haute, IN · On-site
$37K/yr
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
State Eligibility Consultant
Richmond, IN · On-site
$37K/yr
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
State Eligibility Consultant
Richmond, IN · On-site
$37K/yr
... integrity of benefits for DFR programs. The SEC is responsible for processing and reviewing tasks, applications, changes, and redeterminations for SNAP, Medicaid and TANF benefits to ensure they ...
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... Demonstrated high level of integrity, client service and leadership skills * Ability to formulate ...
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... Demonstrated high level of integrity, client service and leadership skills * Ability to formulate ...
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... Demonstrated high level of integrity, client service and leadership skills * Ability to formulate ...
... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ... Demonstrated high level of integrity, client service and leadership skills * Ability to formulate ...
Medicaid Program Integrity information
What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?
| Aspect | Medicaid Program Integrity | Medicaid Claims Examiner |
|---|---|---|
| Primary Focus | Detecting and preventing fraud, waste, and abuse in Medicaid programs | Reviewing and processing Medicaid claims for accuracy and compliance |
| Required Credentials | Typically healthcare or compliance certifications, knowledge of Medicaid policies | Healthcare or claims processing certifications, attention to detail |
| Work Environment | Regulatory agencies, government offices, compliance departments | Insurance companies, healthcare providers, government Medicaid offices |
Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.
What are popular job titles related to Medicaid Program Integrity jobs in Indiana? For Medicaid Program Integrity jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Integrity jobs in Indiana look for? The top searched job categories for Medicaid Program Integrity jobs in Indiana are:
What cities in Indiana are hiring for Medicaid Program Integrity jobs? Cities in Indiana with the most Medicaid Program Integrity job openings:
Job description
Flexible Work Location
Flexible Work Location Flexible Work Location, Indiana 46544
The PACE Medicaid Specialist leads all Medicaid eligibility activities across the program, including applications, reactivations, and annual redeterminations. In this role you will own process performance, ensuring consistent execution, accountability, and measurable outcomes.
You will also ensure complete, accurate, and timely submissions to the State of Indiana for approval of prospective participants and continued eligibility of current participants. Through proactive management of applications and redeterminations, this role advances census growth, prevents coverage gaps, and protects participant access to care and program revenue integrity
WHO WE ARE
Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.
The PACE program's vision statement is to provide unmatched, individualized, and joyful care through teamwork that is worthy of praise so that seniors experience the best quality-of-life in their communities. PACE offers seniors and their families the care, nutrition, rehabilitation, transportation, and supportive services they need to remain healthy so that they can live in their own home. Franciscan is known for our mission of caring.
WHAT YOU CAN EXPECT
QUALIFICATIONS
TRAVEL IS REQUIRED:
Up to 50%
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
Flexible Work Location Flexible Work Location, Indiana 46544
The PACE Medicaid Specialist leads all Medicaid eligibility activities across the program, including applications, reactivations, and annual redeterminations. In this role you will own process performance, ensuring consistent execution, accountability, and measurable outcomes.
You will also ensure complete, accurate, and timely submissions to the State of Indiana for approval of prospective participants and continued eligibility of current participants. Through proactive management of applications and redeterminations, this role advances census growth, prevents coverage gaps, and protects participant access to care and program revenue integrity
WHO WE ARE
Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.
The PACE program's vision statement is to provide unmatched, individualized, and joyful care through teamwork that is worthy of praise so that seniors experience the best quality-of-life in their communities. PACE offers seniors and their families the care, nutrition, rehabilitation, transportation, and supportive services they need to remain healthy so that they can live in their own home. Franciscan is known for our mission of caring.
WHAT YOU CAN EXPECT
- Candidate will need to be located within a reasonable commute from either our Greenwood & Lafayette Centers or our Dyer & Michigan City Centers.
- Candidate will be required to travel to the 2 centers located within their territory as well as out in the community as needed to help assist PACE participants.
- Will be reimbursed mileage for travel to other center and while out in the community.
- Practice Hours: Monday - Friday, 8:00 a.m. - 5:00 p.m.
- No Weekends, Evenings, or Holidays
- Own and execute all Medicaid redeterminations, maintaining accountability for continuous participant coverage.
- Proactively manage timelines, prioritizing outreach and follow-up to prevent eligibility gaps and disenrollment.
- Identify, assess, and resolve risks impacting continued eligibility, determining appropriate actions to sustain coverage.
- Oversee Medicaid applications and reactivations, advancing cases from initiation through submission with a focus on timely outcomes.
- Assess applicant readiness in partnership with Intake, resolve eligibility barriers, and establish next steps to support enrollment. Collect, verify, and submit documentation through direct outreach and in-person engagement to reduce delays and improve application completeness.
- Manage application pipelines and coordinate follow-up and escalation with FSSA/DFR to accelerate determinations
- Act as the primary Medicaid eligibility resource for Intake, Social Work, and the interdisciplinary team. Align stakeholders on documentation requirements, timelines, and clear next steps, prioritizing cases based on urgency and impact
QUALIFICATIONS
- High School Diploma/GED- Required
- Associate's Degree- Relevant Field of Study- Preferred
- 2 Years- Direct Medicaid eligibility experience, including applications, reactivations, and redeterminations- Required
- 1 Year- Strong knowledge of Indiana Medicaid eligibility requirements, verification processes, and state systems- Required
- 1 Year- Experience working directly with FSSA/DFR, including escalation of complex eligibility cases- Required
- 1 Year- Proven ability to independently manage cases from submission through resolution with limited oversight- Required
- 1 Year- Experience working with a frail or elderly population- Required
- 1 Year- Experience in PACE, long-term care, or healthcare enrollment- Preferred
- Driver's License - Required
- Auto Insurance - Required
TRAVEL IS REQUIRED:
Up to 50%
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.