- Humana (Indianapolis, IN)
- …costs, administrative expenses and quality/bonus performance + Comprehensive knowledge of Medicare policies, processes and procedures + DSNP experience inclusive of ... Medicare Advantage + Long-term support services; experience working with...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Healthfirst (NY)
- …+ Performs first level review of all marketing materials to ensure compliance with State and Federal guidelines. + Prepares and submits marketing materials ... Provides support to all internal stakeholders during the annual Medicare Go to Market project in preparation for the... Go to Market project in preparation for the Medicare Annual Enrollment Period (AEP). + Contributes to the… more
- Avera (Spencer, IA)
- …home facilities. + Presents and explains Advanced Beneficiary Notices to Medicare patients. Has basic knowledge of diagnosis codes. Also understands, utilizes ... and can explain non- Medicare waivers for non- Medicare patients. + Performs...who may be disabled. Avera is committed to ensuring compliance in accordance with the Americans with Disability Act.… more
- CareOregon (Portland, OR)
- …care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ... as roughly 10,000 baby boomers a day enter the Medicare system. If you receive an offer of employment...Adhere to the organization's policies, procedures and other relevant compliance needs. + Perform other duties as needed. Experience… more
- Humana (Sacramento, CA)
- …interrelate across segments and/or enterprise-wide. **Regional VP of Health Services, Humana Medicare Advantage** As the Regional VP of Health Services, you will ... and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider… more
- Beth Israel Lahey Health (Burlington, MA)
- …Coverage Determinations (LCD's), or Local Medical Review Policies (LMRP's) to ensure compliance with coding guidelines. 2. Stays current on quarterly CCI Edits, ... bi-monthly Medicare Bulletins, Medicare 's yearly fee schedule, Medicare Website, and specialty newsletters. 3. Makes guidelines available via, paper, on-line… more
- US Tech Solutions (RI)
- …requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. + Must apply information provided through multiple ... and Appeals Learning Advocates and management team as needed. + Must maintain compliance at all times with CMS and department standards. + Position requires schedule… more
- UNC Health Care (Hendersonville, NC)
- …in the ambulatory practice setting. Identifies barriers to care plan compliance and provides appropriate education and resources. Works collaboratively with the ... care gap closure or exclusions. Responsibilities: * Under provider supervision, coordinates Medicare visits including Welcome to Medicare , Medicare … more
- US Tech Solutions (May, OK)
- …requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. Must apply information provided through multiple channels ... and Appeals Learning Advocates and management team as needed. Must maintain compliance at all times with CMS and department standards. Position requires schedule… more
- Mount Sinai Health System (New York, NY)
- …payment. This position plays a key role in ensuring the financial health and compliance of the organization and bridges the gap between clinical care and medical ... requires a unique blend of clinical expertise and financial acumen to ensure compliance with healthcare regulations and collaborate with staff to resolve issues and… more