- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …clinical care plans to Risk Adjustment Data Validation (RADV) Timelines. Medicare and Medicaid regulations and billing guidelines and AMA's publication CPT ... coder CPC or CCS-P, and AAPC CRC certification. 2+ years coding, Medicare Risk Adjustment/ Medicare Advantage and/or clinical. Plans experience. Familiarity with… more
- Humana (Harrisburg, PA)
- …determining objectives and approaches to assignments. This role is within the Medicare Finance organization. This role will be required to collaborate with various ... requests and perform valuations that help inform financial strategy related to the Medicare Advantage line of business. **Use your skills to make an impact**… more
- BAYADA Home Health Care (Philadelphia, PA)
- …to fill the position of **Clinical RN Nurse Manager** for our **Philadelphia, PA** Medicare Certified, Home Health office. Do you want to be part of providing care ... and ensuring that all home health nursing services comply with Medicare regulations, accreditation standards, and internal policies. This leadership role supports… more
- Humana (Harrisburg, PA)
- …the core of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid, and other health plans to millions. By integrating insurance ... Strategy team plays a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's total revenue… more
- Highmark Health (Blue Bell, PA)
- …for risk revenue management for all government program products (commercial ACA, Medicare , and Medicaid). Establishes the strategic direction for the Risk Revenue ... comprehensive and accurate diagnosis coding for risk adjusted government programs ( Medicare Advantage, ACA business, and Medicaid). Also work with Care Management… more
- Humana (Harrisburg, PA)
- …includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical… more
- Intermountain Health (Harrisburg, PA)
- …+ Coordinates all aspects of provider enrollment with commercial and government ( Medicare and Medicaid) professional fee payer contracts for an entire market. ... aspects of provider enrollment with Intermountain Health's commercial and government ( Medicare and Medicaid) professional fee payer contracts for an entire market.… more
- CVS Health (Harrisburg, PA)
- …every day. **Position Summary** The Health Coach telephonically outreaches our Medicare population to improve medication adherence and/or HEDIS diabetes and blood ... Renal, Diabetes, Hypertension, Primary Care/Geriatric, Oncology -Managed Care and Medicare experience -Must live in EST/CST -Hardwired Internet Connection… more
- Humana (Harrisburg, PA)
- …best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various multi-disciplinary ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Humana (Harrisburg, PA)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid/ Medicare . Looks for long term improvements of encounter submission processes. Understands… more