Category: MM Curator

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Medicaid Job Hunter: 10/21/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

 
  1. Nurse Medical Management I – Medicaid HCMS | Anthem, Inc.
  2. Association of State and Territorial Health Officials Medical Director Medicaid LOB Job in Detroit, MI
  3. Anthem Health Plans of Virginia Network Relations Consultant Manager (NC Medicaid Alliance Operations) in Cary, NC
  4. Health Insurance Specialist | The Job Network
  5. Managing Consultant – Healthcare Value Transformation CMS-64 State Medicaid/Medicare Audit Services | Navigant
  6. Behavioral Health Care Coordinator
  7. Assistant Director, Provider Relations – Contracts Administration – The Health Plan
  8. Registered Nurse, Atlanta, Georgia
  9. i2i Population Health | Product Solutions Specialist
  10. Nurse Medical Management I – Medicaid HCMS in Fort Worth, Texas, United States

Medicaid Industry Jobs Hunter 10.21.19

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Monday Morning Medicaid Must Reads: October 21st, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS – http://bit.ly/2T7CP7K
In this issue…

Article 1:        Medicaid Spending Rises Even As Enrollment Declines, WIBC.com

Clay’s summary:      I feel for the legislators who keep getting the goal posts moved on them. “Look over here – here’s our new shiny thing that will control costs!” 3 years later: “Well here’s why costs were not controlled those last few years. Can we interest you in a new shiny thing as you consider this year’s budget bill?”
Key Excerpts from the Article:
 Last fiscal year’s Medicaid enrollment was Indiana’s lowest in three years, yet spending was up $800 million.  
Read full article in packet or at links provided

Article 2:        Why Medicaid Enrollment And Fraud Has Exploded Under Obamacare, The Federalist

Clay’s summary:      Those expansion states that keep trying to shame your state into taking the plunge? Their expansion enrollment was 2x what their wisest predictors told them it would be.
Key Excerpts from the Article:
By the end of 2016, enrollment in 24 states that expanded Medicaid enrollment to able-bodied adults exceeded the states’ original projections by an average of 110 percent.
New studies and data suggest two related reasons why: Ineligible individuals getting on (or staying on) the Medicaid rolls, and people dropping private coverage to enroll in Medicaid expansion.
Read full article in packet or at links provided

Article 3:        Childless, able-bodied adults are driving cost and enrollment under Medicaid expansion, Adam Crepeau, The Maine Wire

Clay’s summary:      The young adults without children predicted least likely to enroll in expansion in the study used to sell expansion to Mainers? Yep, they ended up being the ones who enrolled at 5x the rate predicted. Its almost like Bernie clued them into the place to get all that free healthcare he’s been talking about.
Key Excerpts from the Article:
Since Governor Mills signed the executive order when she took office in January, more than 37,000 individuals have enrolled under expansion. According to the Maine Department of Health and Human Services (DHHS), adults without children represent 81 percent of those who have enrolled thus far. Of those individuals, 10,500 of them, or nearly one-third of all enrollees, are between the ages of 19 and 29.
These trends are much different than what was projected in a study conducted this year by the Muskie School of Public Service. Their research indicated that adults between the ages of 19 and 24 were least likely to enroll under expansion. This age group represented just 6.6 percent of eligible low-income, childless adults whereas individuals between the ages of 55 and 64 were expected to make up approximately 45 percent of the expansion population.
Read full article in packet or at links provided
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Medicaid Job Hunter: 10/14/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Medicaid Program / Healthcare Policy Analyst -Austin | Chandra Technologies, Inc
  2. Market Medical Director, Vivida Health Plan | The Job Network
  3. Medicaid Health Systems Administrator 1 | Ohio Department of Medicaid
  4. Director, Consumer Experience & Strategy – Health Plan Products & Services – Great New R -Worcester | Fallon Health
  5. MEQC Health Program Manager | State of Utah
  6. In-Patient Concurrent Review Nurse l or ll (RN) REMOTE – WA State Medicaid (PS28851) in Cerritos, California, United States
  7. Outreach Representative, CareConnections Long Beach, CA | Molina Healthcare
  8. Medicaid Clinical Pharmacy Lead | Humana | LinkedIn
  9. Performance Monitoring Specialist, Clinical at WellCare
  10. Medicaid Specialist I
 

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Monday Morning Medicaid Must Reads: October 14th, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS – http://bit.ly/2T7CP7K
In this issue…

Article 1:        AAFP Objects to Planned End of Medicaid Access Rule, AAFP

Clay’s summary:      The rule is intended to show whether docs get paid enough to “encourage” them to provide Medicaid services, but it takes a good bit of effort to report on that info. And docs don’t like the idea of removing anything intended to make sure they get paid.
Key Excerpts from the Article:
In the rule,(www.govinfo.gov) published in the July 15 Federal Register, CMS noted its intention to ease some of the administrative burden that states currently face in trying to document whether Medicaid payments in fee-for-service systems are high enough to encourage physicians and other health care professionals to provide services to Medicaid beneficiaries.
The proposed rule outlines CMS’ contention that by compelling states to collect specific information, the agency “excessively constrains state freedom to administer the program in the manner that is best for the state and the Medicaid beneficiaries in the state.”
The AAFP noted its shared commitment to reducing administrative burden for states and clinicians, but argued that the proposed rule, as written, would likely negatively affect Americans in rural areas, as well as some of the country’s most vulnerable patient populations that depend on Medicaid for health care services.
Read full article in packet or at links provided

Article 2:        Walmart’s First Healthcare Services ‘Super Center’ Opens, Bruce Japsen, Forbes

Clay’s summary:      Amazon is creating empty shelves / space in those huge Walmart buildings. So far Bezos hasn’t figure out how to do 2 day shipping on a doctor’s visit, so Walmart is opening clinics. CVS, too…
Key Excerpts from the Article:
 The retailers see 10,000 baby boomers aging into Medicare coverage each day and are also looking to fill emptying space in their brick and mortar stores in the face of changing consumer shopping habits driven by online retail giant Amazon, which is also exploring new ways to get into the healthcare business but has yet to offer face-to-face personalized healthcare services for customers…
This year, CVS has said its new health hub concept store will reach four U.S. metropolitan areas and 50 locations by the end of this year as part of a major expansion. CVS said the HealthHub rollout will grow to 1,500 locations by the end of 2021, or about 500 HealthHubs a year, CVS chief executive officer Larry Merlo told analysts on the company’s second quarter earnings call.
Read full article in packet or at links provided

Article 3:        Medicaid expansion increased ED use, study shows, Modern Healthcare

Clay’s summary:      A Medicaid card provides immunity to medical debt, so ED visits went up. You don’t say?
Key Excerpts from the Article:
Patients under Medicaid don’t have to fear debt collection, removing one big barrier that could deter someone from a hospital visit. Those visits may be perceived as more convenient than a regular doctor’s office visit even if they’re more expensive to Medicaid, since the patient doesn’t have to find a physician who accepts his or her plan…”This pattern of estimates is intuitive,” they wrote. “Medicaid expansion effectively lowers the price of an ED visit for the patient, and so we would expect for an increase in visits for those that are discretionary.”In general, people who qualified for Medicaid under the expansion went to doctors or hospitals at higher rates than the people who didn’t qualify. The authors said that suggests basing the expansion on income rather than specific categories of need “successfully targeted” the people most in need of medical care.
That suggestion held in non-expansion states as well. The people in those states who bought plans on the individual market exchanges with the aid of income-based subsidies were also those who most needed medical care.
Read full article in packet or at links provided
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Medicaid Job Hunter: 10/07/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Supervisory Health Insurance Specialist | Centers for Medicare & Medicaid Services
  2. Medicaid Eligibility Advocate – Nashville | TriStar Skyline Medical Center
  3. Medicaid Field Care Manager; Behavioral Health | Humana
  4. Director of Pharmacy | Medicaid Managed Care PBM | The Job Network
  5. Manager, Ethics & Compliance at Centene Corporation
  6. Manager, Medicaid Program | Heatlh People Inc.
  7. Program Specialist V | Texas Health and Human Services
  8. Vice President & Chief Executive Officer Health Plan In | Banner Health System
  9. Prior Authorization/Utilization Review Nurse | iCare Independent Care Health Plan
  10. Health Plan Specialist I (Inbound)
 

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Monday Morning Medicaid Must Reads: October 7th, 2019

2019 10 07 MMMRHelping you consider differing viewpoints. Before it’s illegal.
other MMRS – http://bit.ly/2T7CP7K
In this issue…
Article 1:

New Bombshell Report Reveals Obamacare’s Epic Medicaid Waste, Sally Pipes, Forbes

Clay’s summary:      It’s almost as if when you pass a gigantic, economy transforming bill without reading it, forcing everyone to go along or else they’re evil- and there happen to be some train wrecks, negatives we find out years later. But I have no doubt the Medicaid Left will only ever sing its praises as if it is a complete and total success until the end of time.
Key Excerpts from the Article:
...according to a new study published by the National Bureau of Economic Research, it’s the insurer of record for a significant number of middle-class Americans. The cost to taxpayers? Hundreds of millions of dollars.
The culprit for this epic amount of government waste shouldn’t be a surprise—Obamacare…By the end of 2016, some 11.5 million able-bodied adults had enrolled in Medicaid because of the expansion, more than double the original enrollment projections. This brings the total number on Medicaid to 65.6 million.The cost of the expansion has been higher than expected, too—76% more per person.
Read full article in packet or at links provided

Article 2:        Are the Right People on Medicaid? – Flathead Beacon, Bob Keenan, Tom Burnett

Clay’s summary:      Most people don’t mind taking money from them (“taxes”) to help their needy neighbor. They do mind when it turns out bennies are not actually eligible. Even in Montana.
Key Excerpts from the Article:
... 25% of Medicaid expansion enrollees were likely ineligible in both California and New York. A state audit in Louisiana found 82% of expansion enrollees were ineligible at some point during the year they were enrolled. 25% of Medicaid expansion enrollees were likely ineligible in both California and New York. A state audit in Louisiana found 82% of expansion enrollees were ineligible at some point during the year they were enrolled.
Read full article in packet or at links provided

Article 3:        Analysis: Medicaid deals offer election headache for Edwards, AP, Melinda Deslatte

Clay’s summary:      Sometimes Medicaid helps you get elected (like when you ran on expansion Mr. Edwards). Sometimes it might get you un-elected (like when you are blamed for the current procurement fiasco with MCOs). Good luck with that.
Key Excerpts from the Article:
…The contracts pay for private companies to oversee care for about 90% of Louisiana’s Medicaid enrollees, an estimated 1.5 million people — mostly adults covered by Medicaid expansion, pregnant women and children. The contracts are among the largest in state government, accounting for roughly one-quarter of the state’s annual operating budget…Losing bidders for the next round of multibillion-dollar contracts to manage health services for Medicaid patients are accusing the Edwards administration of bias and conflicts of interest. Republican and Democratic lawmakers are worrying publicly about whether health care access will be disrupted for half a million Medicaid enrollees, many of whom are in Edwards’ expansion program.
Read full article in packet or at links provided
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Medicaid Job Hunter: 09/30/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Health Insurance Specialist | Centers for Medicare & Medicaid Services
  2. Project Manager with HMO, Medicaid and Medicare experience | The Job Network
  3. Health Care Policy & Financing Researcher and Writer | State of Colorado
  4. Research Associate – Health Insurance Access and Value Based Care | IMPAQ International
  5. Medicaid Liaison | McLaren Health Care
  6. Medicaid & Medicare Claims Educator
  7. Nurse | Centers for Medicare & Medicaid Services
  8. Utah Medicaid Case Coordinator | Avalon Health Care Group
  9. Payment Reform Program Officer | Center for Health Care Strategies, Inc.
  10. Managed Care Coding Specialist (MPS2/MPOI)
 
 

Medicaid Industry Jobs Hunter 09.30.19

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Medicaid Job Hunter: 09/23/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Medicaid Medical Director – Medical Specialist 4 – Job at Minnesota Department of Human Services
  2. STAR+PLUS Manager/Service Coordination/RN
  3. State of Florida 68010652-Systems Project Consultant Job in Tallahassee, FL
  4. (16) Medical Director Medicaid LOB | WellCare Health Plans | LinkedIn
  5. MyFlorida 68059450 – Government Operations Consultant II in Virtual, USA, United States
  6. General Eligibility Policy Specialist. | State of Colorado | LinkedIn
  7. Director Office Of Strategy Performance and Results Job in BALTIMORE, MD
  8. Chief Medical Officer Aetna Better Health of KS (Medicaid) Job at Aetna in Overland Park, Kansas
  9. University of Utah Health Health Plans Quality Improvement Specialist in Murray, Utah, United States
  10. Healthcare Management Solutions Medicaid Compliance Reviewer Job in Fairmont, WV
 

Medicaid Industry Jobs Hunter 09.23.19

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Medicaid Job Hunter: 09/16/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Nurse Case Manager | Fallon Health
  2. Manager, Conversion Strategy | Centene Corporation 
  3. Nurse Auditor – Medicare/Medicaid Review – Home Based | Delmarva Foundation 
  4. Medicaid Liaison | McLaren Health Care
  5. Medicaid Eligibility Advocate | HCA Healthcare
  6. Payment Reform Program Officer
  7. Health Insurance Specialist
  8. Director Medicaid Plan Marketing | Anthem, Inc.
  9. Medical Director Medicaid LOB | WellCare Health Plans
  10. Program Officer – Medicare-Medicaid Integration/LTSS

Medicaid Industry Jobs Hunter 09.16.19

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Medicaid Job Hunter: 09/09/2019

We scour the internets for Medicaid jobs listings to save you time.

In this packet…

  1. Manager-Care Management Medicaid | PacificSource Health Plans
  2. Chief Medical Officer – CMO Managed Care | e- Health Jobs
  3. Director – Healthcare Medicaid Value Transformation – Multiple Locations | Navigant
  4. Health Care Business Analyst(Medicaid & MMIS) | Computer Consultants International, Inc.
  5. Health Plan President | Surf Search Inc
  6. Medicaid Community Health Worker – Kentucky Medicaid | Humana
  7. Inbound Contact Representative – Provider Medicaid | Jobs @ TheJobNetwork
  8. State President, Texas – Medicaid LOB | WellCare Health Plans
  9. Supervisory Health Insurance Specialist | Centers for Medicare & Medicaid Services
  10. medical Health Care Program Analyst | State of Florida

Medicaid Industry Jobs Hunter 09.09.19