Russell, KY · On-site
$15.75 - $20.25/hr
Utilize the Medicaid Waiver Management Application (MWMA) for all reporting and program integrity documentation. * Lead the transition of care for adolescents into adult medicine while navigating ...
Quick apply
Russell, KY · On-site
$15.75 - $20.25/hr
Utilize the Medicaid Waiver Management Application (MWMA) for all reporting and program integrity documentation. * Lead the transition of care for adolescents into adult medicine while navigating ...
Russell, KY · On-site
$15.75 - $20.25/hr
Utilize the Medicaid Waiver Management Application (MWMA) for all reporting and program integrity documentation. * Lead the transition of care for adolescents into adult medicine while navigating ...
Quick apply
Russell, KY · On-site
$15.75 - $20.25/hr
Utilize the Medicaid Waiver Management Application (MWMA) for all reporting and program integrity documentation. * Lead the transition of care for adolescents into adult medicine while navigating ...
Wellness program to support your well-being * Career growth opportunities; we love promoting from ... Integrity, discretion, and professionalism EQUAL OPPORTUNITY EMPLOYER The Facility is an equal ...
Quick apply
Wellness program to support your well-being * Career growth opportunities; we love promoting from ... Integrity, discretion, and professionalism EQUAL OPPORTUNITY EMPLOYER The Facility is an equal ...
$122 - $203/hr
Direct experience with Medicaid systems and data sources such as MMIS, data warehouses/lakes, eligibility systems, provider systems, managed care data, or program integrity tools.* Experience with ...
$122 - $203/hr
Direct experience with Medicaid systems and data sources such as MMIS, data warehouses/lakes, eligibility systems, provider systems, managed care data, or program integrity tools.* Experience with ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
New
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
New
Paris, KY · On-site
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Paris, KY · On-site
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Paris, KY · On-site
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Paris, KY · On-site
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Lebanon, KY · On-site
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Lebanon, KY · On-site
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
... Program Integrity Contractor (UPIC), Medicare Administrative Contractor (MAC), Medicaid, commercial payer, and other regulatory audits. What We're Looking For: ➤ Bachelor's in business, healthcare ...
... Program Integrity Contractor (UPIC), Medicare Administrative Contractor (MAC), Medicaid, commercial payer, and other regulatory audits. What We're Looking For: ➤ Bachelor's in business, healthcare ...
Russell, KY · On-site
$15.75 - $20.25/hr
Utilize the Medicaid Waiver Management Application (MWMA) for all reporting and program integrity documentation. * Lead the transition of care for adolescents into adult medicine while navigating ...
Quick apply
Russell, KY · On-site
$15.75 - $20.25/hr
Utilize the Medicaid Waiver Management Application (MWMA) for all reporting and program integrity documentation. * Lead the transition of care for adolescents into adult medicine while navigating ...
$100 - $232/hr
Position Summary Revenue Integrity Informatics is seeking a Lead Director - Revenue Integrity ... Align risk adjustment programs with state Medicaid models (e.g., CDPS, CRG, or state-specific ...
$100 - $232/hr
Position Summary Revenue Integrity Informatics is seeking a Lead Director - Revenue Integrity ... Align risk adjustment programs with state Medicaid models (e.g., CDPS, CRG, or state-specific ...
$180 - $215/hr
Align employment practices with Medicaid provider enrollment rules, Electronic Visit Verification (EVV) mandates, and state program integrity requirements.* Advise on background check compliance ...
$180 - $215/hr
Align employment practices with Medicaid provider enrollment rules, Electronic Visit Verification (EVV) mandates, and state program integrity requirements.* Advise on background check compliance ...
Louisville, KY · On-site
$150K/yr
As a Compliance Lead for our Medicaid business, you will be part of a team who develops and ... and abuse program integrity program. What makes you successful: * Demonstrated ability to ...
Louisville, KY · On-site
$150K/yr
As a Compliance Lead for our Medicaid business, you will be part of a team who develops and ... and abuse program integrity program. What makes you successful: * Demonstrated ability to ...
$150K/yr
As a Compliance Lead for our Medicaid business, you will be part of a team who develops and ... and abuse program integrity program. What makes you successful: * Demonstrated ability to ...
$150K/yr
As a Compliance Lead for our Medicaid business, you will be part of a team who develops and ... and abuse program integrity program. What makes you successful: * Demonstrated ability to ...
$150K/yr
As a Compliance Lead for our Medicaid business, you will be part of a team who develops and ... and abuse program integrity program. What makes you successful: * Demonstrated ability to ...
New
$150K/yr
As a Compliance Lead for our Medicaid business, you will be part of a team who develops and ... and abuse program integrity program. What makes you successful: * Demonstrated ability to ...
New
| 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.
For Medicaid Program Integrity jobs in Kentucky, the most frequently searched job titles are:
The top searched job categories for Medicaid Program Integrity jobs in Kentucky are:
Cities in Kentucky with the most Medicaid Program Integrity job openings:
$15.75 - $20.25/hr
Full-time
Re-posted 24 days ago
What is the Child Waiver for Kentucky?
The Community Health for Improved Lives and Development (CHILD) waiver is a new Kentucky Medicaid program designed to provide "wraparound" support. It helps children with significant behavioral or developmental challenges live safely at home instead of in a hospital or residential facility.
Why Choose Community Inclusion?
At Community Inclusion, we believe that strong organizations are built by strong teams. Our work is centered on dignity, inclusion, and empowerment—supporting individuals, families, and communities through services that create stability, independence, and meaningful opportunity. When you join Community Inclusion, you become part of a collaborative leadership team focused on building a positive workplace culture, supporting employee growth, and ensuring the organization continues to serve the community with excellence.
Position Description
The Case Manager leads the coordination and advocacy functions for participants enrolled in the CHILD Waiver program. This role serves as the primary architect of the Person-Centered Service Plan (PCSP), ensuring that every child’s goals for independence and community integration are met. The Case Manager manages the complexities of the MWMA, facilitates transition planning, and acts as a neutral advocate.
Requirements:Key Responsibilities
Assistance for everyone can range from occasional verbal reminders to full staff assistance, depending on the individual's functioning level.
Qualifications
Education & Training and/or Experience:
Language/Math/Reasoning Ability:
Licenses, Police Check, Registration, and Certifications:
