- Molina Healthcare (Joliet, IL)
- …to families and individuals who qualify for government-sponsored programs, including Medicaid, Medicare , Managed Long-Term Services and Support (MLTSS) and - in some ... years of management experience. + Working knowledge of Medicaid and Medicare products. **Preferred Education:** + Master's Degree in Business, Health Administration,… more
- Zelis (Plano, TX)
- …claim data, with a focus on various pricing methodologies including Medicare , Medicaid, and commercial reimbursements. This role involves leveraging data to ... analysis, and reporting. + Understand claim payment methodologies such as Medicare , Medicaid, and Commercial Reimbursement. + Create visualizations and dashboards to… more
- HCA Healthcare (Austin, TX)
- …public nursing or acute hospital nursing experience + Familiar with Medicare home health regulations, documentation requirements, ICD-10 coding and PPS (Strongly ... health, public nursing or acute hospital nursing experience Familiar with Medicare home health regulations, documentation requirements, ICD-10 coding and PPS… more
- SUNY Upstate Medical University (Syracuse, NY)
- …of certification must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible ... for Medicare Enrollment within 6 months of hire (eligibility criteria for NP requires National Certification through AANP or ANCC, and Master's Degree) (eligibility… more
- SUNY Upstate Medical University (Syracuse, NY)
- …of certification must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible ... for Medicare Enrollment within 6 months of hire (eligibility criteria for NP requires National Certification through AANP or ANCC, and Master's Degree) (eligibility… more
- Trinity Health (Clive, IA)
- …potential financial impact on the member organizations of major changes in Medicare and Medicaid policies. Assists in related advocacy efforts regarding such ... adhere to federal, state and other third-party reimbursement regulations. Prepares Annual Medicare , Medicaid, Blue Cross and Tricare cost reporting for the Trinity… more
- WellSpan Health (York, PA)
- …requests, Pa Health Care Cost Containment Council financial data reporting and Medicare Provider enrollment and change reporting. + Independently compiles data for ... maintaining staff time records. + As part of the Medicare annual cost reporting process, works with employed physicians...of physician time studies to optimize reimbursement from the Medicare program related to Medical Education Programs. + Trains… more
- CenterWell (Boynton Beach, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality… more
- Highmark Health (Dover, DE)
- …and 3 years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. OR + Bachelor's degree in Social Work with five years' experience ... in Acute or Managed Care/ experience with Medicaid or Medicare populations **Preferred** + Experience working with high-risk pregnant women OR experience working… more
- Amergis (French Camp, CA)
- …InterQual assessments + Collaborating with multidisciplinary teams + Applying current Medicare guidelines + Clinical documentation and critical thinking ?? Required ... experience + Utilization Review experience + InterQual experience + Knowledge of Medicare guidelines + Experience with PERFORMANT or CDCR denials (preferred) ??… more