- Ochsner Health (New Orleans, LA)
- …with accreditation standards, state and federal licensure or regulations, Medicare , Medicaid, and other regulations, guidelines, requirements, and statutes as ... applicable. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable… more
- Dignity Health (Bakersfield, CA)
- …population health priorities. - Supporting cross market/value-hub value programs, eg. Medicare Shared Savings (MSSP) - Engaging with EPH leadership across ... CommonSpirit Health's Clinically Integrated Networks, identifying and spreading administrative best practices. **Job Requirements** **Minimum Qualifications:** - Minimum 8 years experience in systems integration, operations management - Bachelors degree -… more
- GRAIL (Washington, DC)
- …with **healthcare coverage, reimbursement, and innovation policy** , including Medicare and other federal programs. + Established **network of relationships** ... in Congress and across key industry trade associations. + Exceptional ability to **anticipate and interpret policy and political trends** , crafting proactive strategies to advance organizational goals. + A **strategic communicator** - persuasive, diplomatic,… more
- Molina Healthcare (MI)
- …successful launches of new processes, systems, and operational models across Medicaid, Medicare , and Marketplace lines of business. We are seeking a leader with ... proven experience in **launch planning, execution, and post-implementation stabilization** . **Key responsibilities include:** + Leading operational readiness efforts for new processes, systems, and operational initiatives across provider data and… more
- Avera (Creighton, NE)
- …the department, hospital, and Avera. + Maintains basic knowledge of Medicare reimbursement principles, understands and addresses to applicable laws and regulations, ... reviews and updates departmental policies and practices to reflect current regulations. + Supports Avera's strategic goals and develops the departmental goals accordingly. + Responsibilities include interviewing, hiring, developing, training, and retaining… more
- AdventHealth (Orlando, FL)
- …nation. We are a leading provider of cardiovascular and thoracic services among Medicare patients with national rankings that include: #1 in Cardiology volume, #1 in ... Vascular Surgery volume, #5 in Thoracic Surgery volume and #8 in Open Heart Surgery volume. The AdventHealth Heart, Lung and Vascular Institute is centered in a tertiary facility known as AdventHealth Orlando with a newly opened Ginsburg Tower. This 15-story… more
- AdventHealth (Altamonte Springs, FL)
- …relevant experience in healthcare finance, preferably in reimbursement including Medicare , Medicaid reimbursement and regulatory cost reporting Strong background in ... accounting and financial analysis Strong and proven leadership skills Expert in Medicaid program reimbursement laws and regulations Ability to research and interpret Medicaid laws and regulations Possesses a detailed understanding of governmental payment… more
- Sanford Health (Sioux Falls, SD)
- …complaints, and grievance processes across all product lines, including ACA, Commercial, Medicare Advantage, Medicaid, DSNP, and ISNP. This role ensures adherence to ... all state, federal, CMS, HHS, and quality regulations governing appeals and grievance resolution. Lead and manage the end-to-end appeals and grievances process for all product lines, ensuring compliance with federal and state requirements. Oversee the intake,… more
- AbbVie (Irvine, CA)
- …strategy for the Eye Care Brands across all payer channels (eg Commercial, Medicare , Medicaid, and VA). This individual will be required to effectively orchestrate ... communication and alignment across US Market Access channel teams as well as serve as the subject matter expert for an Eye Care Integrated Brand Teams. Leverage data and analytics, along with customer insights to make strategic decisions for the Eye Care… more
- University of Miami (Miami, FL)
- …+ Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population preferred + ... Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of Hierarchical… more