- Cognizant (Boston, MA)
- …based on the review of clinical documentation in accordance with Medicare , Medicaid, and third-party guidelines. . Effectively document and log claims/appeals ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… more
- BAYADA Home Health Care (Wilmington, MA)
- …and sick leave, vision, dental and medical health plans, employer paid life insurance , 401k with company match, direct deposit and employee assistance program + To ... effective fiscal management of your caseload by monitoring metrics (admissions, % Medicare , referrals rejected by reason, etc.) + Scheduling Managers will partner… more
- BAYADA Home Health Care (Hyannis, MA)
- …Support the team in effective fiscal management by monitoring metrics (admissions, % Medicare , referrals rejected by reason, etc.) + Partner with the team and ... preferred, Associates at minimum. + Prior knowledge of/experience with Medicare and OASIS a plus + Prior medical office...vision, dental and medical health plans, employer paid life insurance , 401k with company match, direct deposit and employee… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …contracting and in-depth understanding of GPO/PBM/National and Regional Health Plan business models, Medicare Part D, Medicare Part B, 340B, and the changing ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… more
- Evolent (Boston, MA)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . . No history of disciplinary or legal action by a state medical… more
- Evolent (Boston, MA)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- ABBTECH Professional Resources, Inc. (Boston, MA)
- …SAFe Product Owner or SAFe Agilist. Experience working with the Centers for Medicare and Medicaid Services (CMS) and/or health insurance /heath care experience * ... requests Salesforce Business Analyst to remotely to support the Centers for Medicare & Medicaid Services (CMS) activities. As a Salesforce Business Analyst… more
- Evolent (Boston, MA)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- Fallon Health (Webster, MA)
- …innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that ... by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. **About… more
- Evolent (Boston, MA)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more