• Director Managed Care Contracting

    Houston Methodist (Houston, TX)
    …care payers include commercial payers, separate transplant contracts, Medicare Advantage, Medicaid Health Maintenance Organizations (HMOs), International, behavioral ... health, worker's compensation, student insurance , bundled payment contracts, quality metric bonus program and risk contracts. The Director position responsibilities… more
    Houston Methodist (09/12/25)
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  • Market CMO

    CenterWell (Norfolk, VA)
    …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... improving consumer experiences **Preferred Qualifications** + Knowledge of Medicaid and Medicare programs + Excellent oral and written communication skills + Good… more
    CenterWell (09/12/25)
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  • Internal Medicine Associate Residency Program…

    Dignity Health (Chandler, AZ)
    …Relocation allowance for applicable physicians + CME benefits + Excellent malpractice insurance + Faculty appointment at Creighton University School of Medicine at ... Leapfrog Group. MGMC was given a 5 star overall Medicare rating while CRMC received a 4 star Medicare rating. DHMG-IM Chandler is a 17 exam room, ultra-modern… more
    Dignity Health (09/12/25)
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  • Mental Health Therapy Aide (MHTA) - Direct Care…

    New York State Civil Service (Buffalo, NY)
    …a generous benefits package including:* NYS medical, dental, & vision insurance * Access to tuition assistance programs* Excellent opportunities for advancement & ... rate ($52,413) and Geographic Pay Differential ($4,000). NOTE:Medicaid and Medicare : In order to be eligible for appointment and...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
    New York State Civil Service (09/12/25)
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  • Patient Access Representative

    UCLA Health (Santa Monica, CA)
    …Collection of accurate demographic information, review and interpretation of insurance benefits + Obtaining prior authorizations, cash collections, interaction with ... public assistance programs (ie Medi-Cal, CCS) + Implementation of Medicare requirements, interaction with physicians/office personnel as well as other hospital… more
    UCLA Health (09/12/25)
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  • Appeals and Grievance QA Auditor

    Point32Health (MA)
    …include experience utilizing an appeals & grievances software platform. Prior A&G Medicare experience. + Preferred: **Skill Requirements** + High attention to detail ... Office Suite (ie, Excel, Word, Outlook). + Knowledge of Medicare Part B, C & D including HIPAA and...+ Paid time off + Employer-paid life and disability insurance with additional buy-up coverage options + Tuition program… more
    Point32Health (09/12/25)
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  • Physician Coding Auditor

    MedKoder (Mandeville, LA)
    …and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer guidelines to ensure receipt of ... guidelines by the AMA, ICD-10-CM coding and guidelines, and Medicare and Medicaid billing policies for professional services. +...* 401K and Profit Sharing * STD, LTD, Life Insurance , and FSA Program * Paid AAPC and AHIMA… more
    MedKoder (09/11/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …with patients, families, caregivers, interdisciplinary team members, external agencies, insurance companies as needed to effectively execute discharge planning ... + Assures completion of discharge forms, ie Important Message from Medicare , PRI, and transportation within established timeframes and according to state/federal… more
    Ellis Medicine (09/11/25)
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  • Case Management Associate

    Ellis Medicine (Schenectady, NY)
    …in the chart. Assists Case Manager with medication prior authorizations. Provides Medicare Important Message to Medicare beneficiaries per CMS Conditions of ... MIDAS per policy. Prints/copies the chart to fax or send for insurance denials or quality improvement organization appeals. * Denial Management Activities; Assists… more
    Ellis Medicine (09/11/25)
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  • Physician - Internal Medicine Hospitalist

    Kelsey-Seybold Clinic (Shenandoah, TX)
    …insurers to offer value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to ... achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more
    Kelsey-Seybold Clinic (09/11/25)
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