- Aston Carter (Valencia, CA)
- …device industry. Responsibilities + Develop and execute strategies to secure coverage, reimbursement , and pricing for medical devices across Medicare , Medicaid, ... strategic Market Access Manager to spearhead efforts in securing coverage, reimbursement , and pricing for cutting-edge medical devices. This role demands extensive… more
- Cognizant (Sacramento, CA)
- …requirements and seek clarification when gaps are identified. + Interpret paper contracts for reimbursement + Work side by side with client team to add PBPs. + ... cautionary reduction functionality. + QNXT SMEs with experience in Medicare Benefit. + Experience with items like Cost Share....Have worked with QCS. + Familiarity with Medicaid and Medicare programs are minimum requirements, as well as knowing… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, Business Data Analyst is instrumental in independently developing the detailed requirements ... + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or...model, capitation and other managed care IPA and provider reimbursement methodologies. + Strong knowledge of physician and facility… more
- Humana (Los Angeles, CA)
- …preferably in the health care or insurance industry, and specifically in Medicare Advantage products + Exceptional leadership and management skills, and the ability ... **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional… more
- Dignity Health (Bakersfield, CA)
- …including payer data sources, including but not limited to; Medicaid, Traditional Medicare , Medicare Advantage, value based programs, among others. 3. Engaging ... analysis to demonstrate insights and trends related to patient engagement, Medicare risk adjustment, STARS/HEDIS, Medical management, and program effectiveness. 8.… more
- UCLA Health (Los Angeles, CA)
- Description The Business Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison between business units, IT teams, and ... other related field required + Minimum of five years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required +… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician ... records (AIS, UR forms/charts, Peer to Peer log and Medicare forms) and substantiate activity by documentation that is...knowledge of health care service delivery systems and third-party reimbursement + Two or more years' experience working in… more
- Hall Ambulance (Bakersfield, CA)
- …of management experience in a healthcare setting, with expertise in medical billing/ reimbursement . + In-depth knowledge of Federal, State, Medicare , Medi-Cal, ... + Medical Billing & Compliance: Extensive knowledge of billing systems, including Medicare , Medicaid, and private payers, with expertise in regulatory and coding… more
- Sharp HealthCare (San Diego, CA)
- …and assures the appropriate documentation to support accurate financial reimbursement .Conducts chart reviews and identify potential tiers.Identifies and solves ... the IRF-PAI prior to electronic transmission.Performs final coding review of Medicare patients for accuracy of assigned impairment code, diagnosis, CMG,… more
- Nevada County (Grass Valley, CA)
- …including 401(a), 457(b), and Roth options. Nevada County also offers a tuition reimbursement program, and is a qualifying employer for the Public Service Loan ... services. 12 This position requires the ability to bill Medicare for client services. Are you currently able and...services. Are you currently able and willing to bill Medicare as a clinician? + Yes + No +… more