- Molina Healthcare (Carson City, NV)
- …operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... of the role. + Validates findings and test assumptions through data, but lead with contextual knowledge of claims processing, provider contracts, and operational… more
- Humana (Helena, MT)
- …**Additional Information** Typically reports to an Associate Vice President of Health Services , Lead , or Corporate Medical Director, depending on size of ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- NORC (Washington, DC)
- …Area Director for our Applied Health Care Economics team. The incumbent will lead evaluation and health services research projects requiring application of ... on research design, methodology, data analysis, and interpretation for Medicare and Medicaid demonstration evaluations and health services research. + Leading… more
- McLaren Health Care (Detroit, MI)
- …agencies, such as HIPAA, PCMH, OSHA, CLIA and the Centers for Medicare and Medicaid Services (CMS) * Respond to emergency situations quickly and appropriately * ... of the staff (Medical Assistants and Patient Access Representatives). S/he will provide feedback to the staff and recommend corrective action to the Manager… more
- AmeriHealth Caritas (Manchester, NH)
- …the state's Medicaid agency is essential. The Market President will lead the effective and efficient operations of this Health Plan directly and/or indirectly ... medical services meets or exceeds appropriate industry standards. + Provide personal leadership that encourages employee productivity and responsiveness to the… more
- AmeriHealth Caritas (Newtown Square, PA)
- …alignment and mitigate audit risk _Provider Support & Stakeholder Engagement_ + Lead the development of provider engagement strategies that promote transparency ... performance across all ACFC lines of business and products ( Medicaid , Medicare, Exchange, PBM, BH). This role ensures that...Desk function to ensure prompt triage and resolution of provider and internal inquiries + Monitor service … more
- New York State Civil Service (Schenectady, NY)
- …Compliance mailbox and answering questions as they pertain to other service reviews,- Reviewing Medicaid Compliance Liaison's self-disclosures, quarterly ... current Eligibility Letter from the NYS Department of Civil Service , www.cs.ny.gov/rp55/, and be able to provide ...referral service that connects employees with local service providers and support services to address… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... involves close collaboration with program leadership, operations teams, and external provider partners. The ideal candidate will have excellent organizational and… more
- Starfish Family Services, Inc. (Livonia, MI)
- …Childhood services within the home and community settings in accordance with the Medicaid Provider Manual for the State of Michigan and agency guidelines. 9. ... will assist in program development, marketing, staff training and service monitoring for the clinic's Infant Mental Health program....program. 7. Assist in coordination and referrals of support services to families in the program. 8. Provide… more
- University of Southern California (Alhambra, CA)
- …collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an ... quality management, discharge planning assessment, and coordination of post-hospital care services , including transfers to an alternative level of care. As more… more
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