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Medicaid Job Hunter: 3/11/2019

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


In this packet…

1. MEDICAL/HEALTH CARE PROGRAM ANALYST – 68053427 | State of Florida  

2. Nurse Practitioner, Field (Saginaw, MI) | Molina Healthcare  

3. Medicaid Behavioral Health Services Manager | The Children’s Village  

4. Branch Business Manager (medicaid Pas) | Outreach Health Services  

5. Behavioral Health Medical Director – Louisiana Medicaid | Humana  

6. CHC Service Coordinator | UPMC Health Plan  

7. Medicaid Eligibility Advocate | HCA Healthcare  

8. Program Analyst. | Centers for Medicare & Medicaid Services  

9. Supervisory Health Insurance Specialist. | Centers for Medicare & Medicaid Services |  

10. Network Manager CA Medicaid Health Plan | Aetna, a CVS Health Company |  


2019 03 11 – Medicaid Curator – Jobs Hunter

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Medicaid Job Hunter: 3/4/2019

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


In this packet…

  1. HEDIS Retriever (Seasonal) job at Metroplus Health Plan in New York, NY
  2. CARE MANAGER
  3. Senior Director, Medicaid Encounters Operations | Evolent Health
  4. Project Manager – Medicaid Services | Wisconsin Department of Health Services
  5. Manager, Health Policy | Fidelis Care |
  6. Nurse Case Manager Case Management | PacificSource Health Plans |
  7. Senior Analyst, Medicaid ACO | Steward Health |
  8. Medicaid Behavioral Health Services Manager | The Children’s Village |
  9. Director- Value Transformation Medicaid Health – Professional Hourly Multiple locations | Navigant
  10. Health Care Business Analyst(Medicaid & MMIS)(Job ID:WISCJP00014393) | Computer Consultants Group, Inc. |
  11. Supervisory Physician. | Centers for Medicare & Medicaid Services |
  12. Medicaid Eligibility Specialist | Tri-County Care CCO |
  13. MVP Health Care REPRESENTATIVE, CARE CENTER MEDICAID Job in Tarrytown, NY

2019 03 04 – Medicaid Curator – Jobs Hunter

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Monday Morning Medicaid Must Reads: Feb 18, 2019

Helping you consider differing viewpoints. Before it’s illegal.

In this issue…
Article 1:     Maryland Mulls Medicaid Reimbursement for Telemental Health Services
 
Clay’s summary:     I have said for years there’s lots of good reasons to move MH/BH into telehealth.
Key Excerpts from the Article:
“Tele-behavioral health can help improve the efficiency and effectiveness of our provider workforce and remove unnecessary obstacles to provide treatment for MassHealth members who have difficulty leaving their home environment, who live in rural areas, and or have other unique needs,” Dan Tsai, MassHealth’s Assistant Secretary, said in a press release. “In addition, behavioral health providers are also incentivized to promote and utilize telehealth services and are reimbursed at the same rates as in-person visits.”
 
Read full article in packet or at links provided

Article 2:     Texas announces record $236M Medicaid fraud settlement
 
Clay’s summary:     State settles for pennies on the dollar (compared to original damages sought); re-named tech behemoth ready to put legacy brand behind it so it can win some new MITA bucks.
Key Excerpts from the Article:
Texas hired Xerox in 2004 to evaluate applications for Medicaid-funded dental procedures. The company was supposed to have dental professionals carefully review each application to make sure the tooth repairs were medically necessary, the standard for Medicaid to cover them.
 
According to the lawsuit, however, the company did little more than rubberstamp the paperwork. Under pressure to keep pace with the exploding number of applications from dentists and orthodontists, Xerox hired untrained workers who often barely glanced at the medical records, molds and x-rays, spending only minutes on each application in some cases, court records show. Those who didn’t keep pace were reprimanded. The company employed a single dentist to review and sign off on several hundred preapproval applications per day.
 
Read full article in packet or at links provided

Article 3:     Passport sues Kentucky over Medicaid cuts – Louisville Business First
 
Clay’s summary:     In which Passport says mean things.
Key Excerpts from the Article:
 
Passport alleges that the cuts to its payments and the increase to its competitors’ payments “are the result of either an improper motive to harm or eliminate Passport; a motive to assist one or more of Passport’s competitors in expansion of market share at the expense of Passport; or gross and deliberate indifference to the harm inflicted on Passport, its 315,000-plus members, its employees and the communities it serves generally.”
Read full article in packet or at links provided
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Medicaid Job Hunter: 2/18/2019

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


In this packet…

1.    Medicaid Behavioral Health Outreach Coordinator – Four Corners Region, CO  UnitedHealth
2.    Dir Medicaid Plan Marketing in Indianapolis IN USA – Anthem, Inc
3.    Brigham & Women’s Hospital(BWH) SOCIAL WORKER – MEDICAID ACO (LCSW)
4.    Medicaid Care Advocate – Field Based in San Diego County – Telecommute for Washington State
5.    Care Manager_LVN_LPN | WellCare Health Plans
6.    Health Insurance Specialist Job in CHICAGO, IL
7.    Integrated Care Mgr (RN) | Optima Health
8.   Administrative Assistant and Office Coordinator | Independent Care Health Plan
9.    DIRECTOR CLINICAL ACCOUNT MANAGEMENT – MEDICAID | Beacon Health Options
10.    PATIENT SERVICES COORD | Optima Health
11.    Director Enterprise Clinical Quality (Medicaid) – Philadelphia | Apploi
12.    RN Case Manager-Medicaid Experience – Part Time | Discovery Senior Living
13.    CTM Coordinator, Sr | WellCare Health Plans
14.    Medicaid Program Manager

2019 02 18 v2- Medicaid Curator – Jobs Hunter

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Monday Morning Medicaid Must Reads: Feb 11, 2019

Helping you consider differing viewpoints. Before it’s illegal.

In this issue…

Article 1:     State wrestles with sizable backlog of Medicaid applications

 
Clay’s summary:     Expansion nearly doubled the AK Medicaid rolls. Doubled. 
Key Excerpts from the Article:
As of Jan. 29, Alaska had a backlog of 15,639 cases of new applicants or renewals on the books. About two-thirds of those, or 10,200 cases, were filed in 2018. The average wait time to be approved is currently 55 days, according to Clinton Bennett, the media relations manager for the Alaska Department of Health and Social Services… That’s the average, but not everyone is waiting that long, he wrote in an email…“Cases that are tagged as emergent, involve a pregnant woman or adding a newborn to any case are being processed on average within 2 days,” he wrote.
Alaska has a fairly large Medicaid population with about 210,276 people enrolled in the Medicaid and CHIP programs as of October 2018, according to the Centers for Medicare and Medicaid Services.
That’s about 24 percent of the state’s total population, and up from 123,335 people enrolled at the end of July 2015, just before the Medicaid expansion took effect in the state.
Though it’s still a sizable backlog, it’s significantly down from the total in May 2018, when the Alaska Ombudsman’s Office published a report highlighting the difficulties in the Division of Public Assistance. At the time, the ombudsman noted a backlog of more than 20,000 cases, itself down from 30,000 in July 2017.
 
Read full article in packet or at links provided

Article 2:     Medicare, Medicaid Enrollment Growing Faster Than Private Coverage

 
Clay’s summary:     New analysis says Care/Caid spending growth is nothing to be concerned about. What do they think we are, idiots? Of course they do. Shut up and pay your taxes. Don’t have opinions about how they are spent.
Key Excerpts from the Article:
 Over the course of 11 years, annual spending growth averaged 5.2% for Medicare and 6% for Medicaid. This eclipsed the 4.4% spending growth among private insurers.
However, spending per enrollee from 2006 to 2017 was markedly lower for public programs compared to their private counterparts. Medicare spending per enrollee amounted to 2.4% per year, Medicaid registered at even lower 1.6%, while private insurance posted 4.4% annually.
Medicaid and Medicare also achieved positive annual enrollment growth rates over the same period of time, 4.3% and 2.8% respectively, while private insurers finished with a flat enrollment growth rate.
The study’s findings conclude that while CMS projects Medicaid and Medicare spending per enrollee to grow sizably over the next decade, both programs have “successfully moderated growth.”
The Urban Institute states that the results indicate that neither program require “major restructuring” to reduce national health spending and that the more concerning spending figures lie in the private insurance market.
The study’s authors support “modest policy proposals,” such as limiting state use of provider taxes in Medicaid or modifications to Medicare cost-sharing.
 
Read full article in packet or at links provided

Article 3:     Medicaid cost concerns are valid

 
Clay’s summary:     An op-ed considers a litany of examples when the state was left to deal with federal funding changes that made programs cost a lot more than originally promised- AND they connect the dots to Medicaid expansion and the “free federal money.” How dare they use logic and past experience???!!? Evil Republicans!
Key Excerpts from the Article:
 Even if the state’s portion of Medicaid expansion costs doesn’t rise, the $150 million price tag is still significant. That $150 million is more than twice the amount required to provide a proposed $1,200 pay raise for every teacher this year. It’s more money than what would be saved if roughly 12,400 inmates were released from state prisons, according to one estimate. It’s more than four times the amount required to eliminate a backlog of local government reimbursements for emergency responses.
Every dollar spent on Medicaid expansion is a dollar that doesn’t go to other needs like schools, roads or public safety. And voter rejection of a 2016 sales tax increase shows limited public appetite for the kind of broad-based tax increases required to avoid such tradeoffs.
The real debate is not simply whether one supports Medicaid expansion, but whether one believes Medicaid expansion should be a higher priority than school funding increases or other causes. And, beyond fiscal considerations, debate should also focus on this question: Does Medicaid expansion improve health outcomes? Much research has found little real improvement.
 
Read full article in packet or at links provided
Posted on

Medicaid Job Hunter: 2/11/2019

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


In this packet…

  1. Community Health Worker – Seattle / King County | Community Health Plan of Washington
  2. Senior Contract Manager | BMC HealthNet Plan/Well Sense Health Plan
  3. Behavioral Health Care Manager (Part Time 10 hours) – Robbinsville | Amerihealth Inc
  4. Claims Analyst IMedicaid – Bend | PacificSource Health Plans
  5. Service Coordinator Associate LTSS, East (Philadelphia) | UPMC Health Plan
  6. Manager, Claims & Contract Support Services | Home State Health Plan, Inc.
  7. Entry Level Opportunity – Healthcare Credentialing | AmeriHealth Caritas
  8. Aetna Inc NC MCD VP, Medicaid Hlth Plan Job in Cary, NC
  9. Personal Care Clinical Manager / Medicaid Home
  10. Health Care Policy & Financing | State of Colorado |
  11. WellCare Health Plans Inc Market VP – Medicaid LOB Job in Houston, TX, United States
  12. Medicaid Director – Healthplan

2019 02 11- Medicaid Curator – Jobs Hunter

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Monday Morning Medicaid Must Reads: Jan 21st, 2019

Helping you consider differing viewpoints. Before it’s illegal.

In this issue…

Article 1:    Feds OK Medicaid Work Requirements in Arizona, Health Leaders Media

Clay’s summary:    This is only the 8th one approved. Must be a fluke.

Key Excerpts from the Article:

Arizona has permission from the federal government to begin imposing work requirements next year on certain Medicaid beneficiaries in the state, but most Native Americans will be exempt, the Centers for Medicare & Medicaid Services announced Friday. Arizona’s waiver is the eighth of its kind, signaling that the Trump administration intends to continue pushing forward with Medicaid work requirements despite pending legal challenges in other states. This is the first waiver to exempt members of federally recognized tribes, resolving a major sticking point with Arizona’s application. State officials had asked CMS to exempt all Native Americans from the new requirement, but Trump administration lawyers said doing so would constitute illegal preferential treatment on the basis of race. The tribes contended, however, that the administration’s position contradicted longstanding legal principles and Supreme Court precedent, as Politico reported.
“There were a lot of complex legal issues here,” CMS Administrator Seema Verma told Politico’s Rachana Pradhan. “I think that we were able to find a middle ground.”…

Read full article in packet or at links provided

Article 2:    Strategies for an Affordable Medicaid Buy-In Option in Colorado, Manatt

Clay’s summary:    We will sell Medicaid on the exchange, and offer subsidized premiums (so nobody really pays for it, except taxpayers). And oh yeah – we’ll pay providers at Medicare rates. What could possibly go wrong?

Full study
Key Excerpts from the Article:

In Colorado, where average Affordable Care Act (ACA) benchmark premiums have increased 71% since 2014, advocates and stakeholders initiated an analysis to evaluate the feasibility and potential impact of a Medicaid buy-in offered outside the individual ACA market, with access to Advanced Premium Tax Credit funding under an ACA Section 1332 State Innovation Waiver. The product would be offered statewide, leverage the current Medicaid infrastructure, provide the same benefits and range of cost sharing as coverage on the state Marketplace (Connect for Health Colorado), and reimburse providers at Medicare rates. The analysis evaluates expected premiums for the buy-in product, the impact of its introduction on existing individual market premiums and the potential for state savings under this program design. The effort was led by a coalition of Colorado health policy advocates, represented by the Colorado Center on Law and Policy, the Colorado Consumer Health Initiative, and the Bell Policy Center. Manatt Health provided the policy and technical support, and Wakely Consulting Group, LLC, conducted the analytical modeling of the proposed program design and scenario alternatives….
 
Read full article in packet or at links provided

Article 3:    Ohio mental health agency closes, blames changes in Medicaid claims, Columbus Dispatch

Clay’s summary:   I’ve seen this movie before.

Key Excerpts from the Article:

Tener said her problems began in July, when the Ohio Department of Medicaid, which had been reimbursing providers for mental-health services provided to Medicaid clients, transferred that responsibility to managed-care insurance plans. Tener said she’s owed $40,000 from the plans, which have been criticized for failing to pay claims in a timely manner or rejecting them for unclear reasons..The Ohio Department of Medicaid has been reviewing the plans continuously and the providers since July 1, said Thomas Betti, the department’s press secretary.
“We understand the significant learning curve with the new system; however, data suggests that month over month, significant improvement is being made in the area of claims payment,” Betti said. “Issues have been minimal and quickly resolved.”Betti said the state sought to assist providers through the transition by disbursing about $146 million, via the managed-care plans, in advance payments from July through October. Those payments are similar to loans; providers are required to repay the money, and the state has instructed managed-care plans to delay repayment schedules, which had been set to begin in November….

Read full article in packet or at links provided

Posted on

Medicaid Job Hunter: 1/21/2019

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


In this packet…
  1. Senior Finance Director, Medicaid Health Plan | ValueOptim
  2. Provider Relations Rep- NJ Medicaid Health Plan
  3. Health Care Business Analyst(MEDICARE & MEDICAID) | Computer Consultants Llc
  4. Director Medicaid Plan Marketing | ValueOptim
  5. Pharmacy Program Manager – Medicaid – SHCN
  6. Medicaid Eligibility Trainer in St Louis MO USA – HCA Health Care
  7. Contract and Network Development Specialist | Independent Care Health Plan
  8. Director, State Behavioral Health – Medicaid LOB with WellCare | Mid West Apply
  9. Clinical Care Manager (RN) – Transition Coordinator – UPMC McKeesport | UPMC Health Plan
  10. AVP, Health Plan Operations Job in Jackson, MS at Molina Healthcare
  11. Manager of Clinical Care Coordination (PA Medicaid) Job in Pittsburgh, PA at Highmark Health
  12. Pres Medicd Health Plan – CA Job in Woodland Hills, CA at Anthem, Inc

2019 01 21- Medicaid Jobs Hunter

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Medicaid Job Hunter: 1/14/2019

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


In this packet…
  1. Medicaid Director – Healthplan Job in Columbus, OH at Konexus Group
  2. Aetna Life Insurance Company Provider Relations Representative- NJ Medicaid Health Plan Job in Princeton, NJ
  3. Senior Finance Director, Medicaid Health Plan – Miami, FL – Magellan Health Services | Ladders
  4. Pharmacy Program Manager – Medicaid
  5. FCHP – Careers
  6. The State of Florida MEDICAL/HEALTH CARE PROG ANALYST Job in Tallahassee, FL
  7. Medicaid ACO Program Specialist – Needham
  8. Director of Business Development & Marketing – NY Medicaid Health Plan (52257BR) at Aetna
  9. Director, Medicaid Challenges, Provider Solutions
  10. Informatics Lead Analyst – NJ Medicaid Health Plan (56036BR)
  11. Dir Medicaid Plan Marketing
  12. StartWire

2019 01 14- Medicaid Jobs Hunter revised