- Integra Partners (Troy, MI)
- …plan medical director + Experience with DMEPOS UM programs, MLTC, Medicaid, or Medicare Advantage + Experience chairing or participating in UM, Credentialing, or ... include but are not limited to: Clinical Leadership & Oversight + Provide day-to-day clinical leadership and oversight to the Utilization Review Medical Director(s)… more
- Banner Health (Phoenix, AZ)
- …preparing and delivering reports and presentations, analyzing, developing, and/or submitting Medicare Advantage and Prescription Drug plan bid pricing tools ... (BHN) is an accountable care organization that joins Arizona's largest health care provider , Banner Health, and an extensive network of primary care and specialty… more
- ChenMed (St. Louis, MO)
- …+ Direct-to-patient sales and marketing experience preferred. + Experience within the Medicare Advantage population strongly preferred. Experience working for a ... of leading the team including, but not limited to, selection, onboarding, performance management, and engagement. + Manages, coaches, and provides training to… more
- CenterWell (Houston, TX)
- …with dobutamine pump + Work experience in electrophysiology + Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... moderate to substantial. The Cardiology Nurse Practitioner serves as a health-care provider who specializes in diagnosis, management, and follow-up of patients with… more
- CenterWell (Tallahassee, FL)
- …PCO has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality ... us put health first** The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned … more
- Corewell Health (Grand Rapids, MI)
- …and detail-oriented Risk Adjustment Reporting Developer to support our organization's Medicare Advantage , ACO, ACA, and other risk-based programs. This ... and ad-hoc reports on RAF trends, HCC capture rates, provider performance , and suspect lists. + Analyze...Provide actionable insights to support coding, CDI, and provider education. + Provider Targeting & Opportunity… more
- Community Health Systems (Franklin, TN)
- …and value-based quality programs. This includes but is not limited to Medicare Traditional and Advantage , Commercial, governmental, ACO, BPCI, CJR, and ... Summary** This position will schedule virtual or (permitting) in-person visits to assigned provider practices. This position serves as a consultant to assist in the… more
- CareFirst (Baltimore, MD)
- …Operations Supervisor supports the execution of the corporate coding strategy across Medicare Advantage , Medicaid, and ACA markets. This role ensures operational ... ensuring timely execution of tasks and adherence to regulatory requirements. Provide coaching, mentorship and performance management to meet productivity… more
- Humana (Frankfort, KY)
- …Qualifications** + Knowledge of or the ability to gather knowledge on Medicare Advantage and Medicaid State Regulations + Certified Professional Coding ... + Lead business partner conference calls and meetings + Provide training when needed for PPI data mining business...correctly in the system) + Minimum of 2 years Provider Payment Integrity (formally known as Financial Recovery) experience… more
- Humana (Atlanta, GA)
- …caring community and help us put health first** Our brokerage business is transforming how Medicare Advantage is sold, and design is at the heart of that change. ... **What You'll Do** + Design best-in-class mobile-first experiences that simplify how Medicare Advantage shoppers navigate their options + Translate insights into… more