- Cedars-Sinai (CA)
- …applicable rules and regulations including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for maintaining routine ... DHCS. Duties and Responsibilities: + Ensures all services provided to Commercial, Medicare and Medi-cal managed care members are in compliance with program… more
- Humana (Fort Lauderdale, FL)
- …Experience with public speaking and presentation skills with healthcare providers + Medicare Risk Adjustment knowledge **Additional Information** Work at home - with ... recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years....over 23 years. CarePlus strives to help people with Medicare , or both Medicare and Medicaid, achieve… more
- OhioHealth (Columbus, OH)
- …performance on value-based contracts or alternative payment programs in the Medicare , Commercial and Medicaid spaces as OhioHealth transitions from a volume ... delivery model. This includes the OhioHealth Clinically Integrated Network (CIN) Medicare Advantage and Commercial contracts, OhioHealth Venture Medicare Shared… more
- CVS Health (Cincinnati, OH)
- …will sell, cross-sell, up-sell, and retain through the use of the Aetna IVL Medicare product portfolio.This role will deploy an operating model that supports 3 days ... shopper initiatives, and state, federal, and CMS requirements for Medicare sales agents and programs + 0-3 Years Experience...or 1 to 2 years' experience of selling multiple Medicare products (ie, Medicare Advantage, Medicare… more
- Masonicare (Wallingford, CT)
- …development and implementation of a comprehensive care plan. 4. Oversees compliance with Medicare Certifications for all Medicare A / PPS patients/residents on ... the designated units. 5. Regularly prepares and distributes Medicare Notices for patients/residents on the designated units. + Communicates with Finance/Billing… more
- Humana (Jefferson City, MO)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... 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… more
- Avera (Fargo, ND)
- …sign-on and relocation assistance. Seeking a candidate with 5+ years of Medicare Cost Reporting experience. Avera offers competitive salary and benefits! **You ... will be responsible for the oversight of reimbursement associated with the Medicare , Medicaid, Tricare and any other governmental cost reports and regulatory support… more
- NORC (Washington, DC)
- …The Program Area Director should have familiarity and experience leading Medicare and Medicaid demonstration evaluations that use experimental or quasi-experimental ... delivery interventions on outcomes and cost using data files derived from Medicare , Medicaid, and commercial payer administrative data. In addition to providing… more
- Stanford Health Care (Palo Alto, CA)
- …and regulatory reports to government agencies, including but not limited to: * Medicare and Medi-Cal cost reports *Financial disclosures to the Department of Health ... timely and accurate filing of annual government cost reports, including Medicare , Medi-Cal, and HCAI submissions. + Maintain comprehensive knowledge of federal… more
- US Tech Solutions (May, OK)
- **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You ... information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a… more