• Medicare Billing Specialist PRN - Susitna…

    Community Health Systems (Palmer, AK)
    …Information Management, or related field preferred + 1-2 years of experience in Medicare billing, medical claims processing, or hospital revenue cycle operations ... As a ** Medicare Billing Specialist** at **Susitna Surgery Center** you'll...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
    Community Health Systems (08/08/25)
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  • Medicare /Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance, Payment Integrity and Analytics… more
    Commonwealth Care Alliance (05/28/25)
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  • Medicare Risk Adjustment Strategy Program…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will manage the ... key relationships throughout the organization including, but not limited to, Medicare Product, Provider Contracting, Health and Medical Management, Actuarial,… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Provider Engagement Analyst, VBP ( Medicare

    Centene Corporation (Providence, RI)
    …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... Payment Initiatives (VBP) will support the expansion and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage… more
    Centene Corporation (07/23/25)
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  • Medicare Long Term Services & Support Care…

    AmeriHealth Caritas (Detroit, MI)
    …and authorizations, including home- and community-based programs. + Collaborate with the Medical Director and care team to develop and monitor treatment ... the Medicare LTSS Care Coordinator manages care coordination for Medicare beneficiaries with complex medical , behavioral health, Long-Term Services &… more
    AmeriHealth Caritas (07/23/25)
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  • Lead Sector Consultant Medicare Sales…

    Henry Ford Health System (Troy, MI)
    GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 million in ... planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for both… more
    Henry Ford Health System (07/24/25)
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  • Medical Director - South Central

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
    Humana (07/11/25)
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  • Director , Corporate Reimbursement…

    RWJBarnabas Health (Oceanport, NJ)
    …reports filings. In partnership with the Vice President of Corporate Reimbursement , the Director will manage the completion of DSH, Medicare Bad Debts, Wage ... Director , Corporate Reimbursement (Hybrid/Remote) - Oceanport, NJReq #:0000180233...as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment… more
    RWJBarnabas Health (06/20/25)
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  • Medical Director - NorthEast Region

    Humana (Bismarck, ND)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (07/25/25)
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  • Housecall Providers Medical Director

    CareOregon (Portland, OR)
    …is a federal contractor and must comply with all federal laws. Job Title Medical Director , NP - Primary Care Requisition # 25064 Exemption Status Exempt ... Direct Reports Physicians, Physician Assistants and Nurse Practitioners Manager Title Sr Medical Director - Clinical Services HCP Department Housecall PC Pay… more
    CareOregon (07/19/25)
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