- Sutter Health (Sacramento, CA)
- …ensuring accurate setup in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores, along with payer codes, for ... Plan (HP) agreements and regulatory requirements. Analyzes and interprets financial performance across multiple HMO products, extracting and synthesizing data from… more
- Johns Hopkins University (Baltimore, MD)
- …and operation of health insurance and managed care programs, including Medicaid and Medicare Advantage . + Deep understanding of the regulatory environment for ... audit teams to ensure effective utilization in completing assigned projects. + Provide day-to-day support for assigned staff, eg create open lines of communication,… more
- New York State Civil Service (Poughkeepsie, NY)
- …maintenance of the Regional Field Office's Policy and Procedural Manual.* Provide technical assistance to Care Coordination Organizations and OPWDD provider ... from the NYS Department of Civil Service, www.cs.ny.gov/rp55/, and be able to provide it to the Human Resources Office upon request. Additional Comments This title… more
- ChenMed (Miami, FL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... be America's leading primary care provider , transforming care of the neediest population. Our mission...goals, and when leading their care teams towards their performance goals. We are an outcomes-focused, value-based organization and… more
- ChenMed (Glenwood, IL)
- …Intermediate computer skills with Microsoft Office Suite products, including Excel and Word + Medicare and/or Medicare Advantage experience a plus + Prior ... will continually seek to improve patient and quality outcomes, monitoring program performance across multiple medical centers. They will be responsible for patient… more
- Humana (Boston, MA)
- …+ **Industry Knowledge** : Familiarity with the healthcare sector, specifically Medicare Advantage , and an understanding of regulatory frameworks and ... be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …tools or analytics platforms preferred. + Familiarity with RFP tracking systems, Medicare Advantage , or value-based care models is highly desirable. Knowledge, ... thrive in a complex, post--Affordable Care Act environment.As a trusted partner to Medicare and commercial payers, we provide scalable, compliant solutions that… more
- New York State Civil Service (Clifton Park, NY)
- …Hab (as needed).* The Senior LPN reviews and submits timecards, completes annual performance evaluations and ensures minimum LPN staffing is met to meet the medical ... LPN scope of practice and works closely with the Residential Nurse to provide optimal care.* Will coordinate and manage individuals' medical appointments. * The… more
- CenterWell (Orlando, FL)
- …Geriatric Medicine. * Active or eligible Florida medical license. * Experience managing Medicare Advantage panel pf patients with understanding of best practice ... * No hospital rounds * Limited phone-only call rotation **Key Responsibilities** * Provide high-quality primary care to adult and senior patients. * Collaborate with… more
- Martin's Point Health Care (Portland, ME)
- …financial departments. Knowledge, Skills, & Abilities: + Knowledge of or experience with Medicare Advantage programs. + Knowledge of or experience with medical ... to evaluate pharmacy utilization, drug cost trends, and program performance . This role provides strategic insights to support pharmacy...cost, clinical or provider contracting analysis. + Excellent oral, written and presentation… more