- CenterWell (Orlando, FL)
- …**Preferred Qualifications:** + Clinical experience in value-based primary care or Medicare Advantage . + Knowledge of EMR optimization, documentation workflows, ... to join our team as a Clinical Coding Education Facilitation Lead - Provider Coding Curriculums. In this role, you'll blend your clinical expertise-especially in … more
- Molina Healthcare (Dallas, TX)
- …member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, ... a managed care setting. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines… more
- ChenMed (Oak Lawn, IL)
- …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
- Centers Plan for Healthy Living (Staten Island, NY)
- …working weekends and requires frequent travel to various Centers Plans or Healthy Living Advantage Care Medicare HMO Plan sites located throughout the five (5) ... boroughs. Territory Management + Maintain Centers Plans for Healthy Living Advantage Care Medicare HMO Plan visibility in the community by monitoring multiple… more
- Humana (Tallahassee, FL)
- …builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider Strategy: ... those relationships to collaborate on how to positively drive provider performance , overcome operational barriers and reduce...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over… more
- Point32Health (Canton, MA)
- …Administration, or related field **Experience** + Required (minimum): 5 years in Medicare Advantage , Medicaid managed care, or healthcare product strategy. + ... including analysis of product performance and competitors + Monitor product performance throughout the year and provide data-driven performance … more
- Ventura County (Ventura, CA)
- …expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal. Skilled in the Medi-Cal Provider Manual and TAR ... codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal. + Medi-Cal Provider Manual for Billing and Policy… more
- Amazon (New York, NY)
- …will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and ... performance compared to plan expectations. Key job responsibilities -Analysis of Medicare Advantage and Accountable Care Organization data primarily -Medical… more
- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... tracking outcome. Assist with research, development, and completion of special performance improvement projects. **ESSENTIAL JOB DUTIES:** + Work cross functionally… more
- Humana (Carson City, NV)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more