- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... required + Five or more years of experience with physician billing and/or coding, required + Three or more...(II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications, required… more
- Molina Healthcare (Dayton, OH)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... Improvement activities. + Stabilizes, improves and educates the Primary Care Physician and Specialty networks. Monitors practitioner practice patterns and recommends… more
- BayCare Health System (Clearwater, FL)
- …with the Marketing Manager and others as needed. + Responsible for Medicare Marketing to support the planning and execution of compliant, results driven ... on investment. + Develops a strong working knowledge of competitors, physician relationships, health care trends and market research, advertising, technology, and… more
- Fallon Health (Worcester, MA)
- …integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of ... interdisciplinary care team that may include the member's primary care physician , medical providers, behavioral health providers, state agencies and/or internal… more
- Centene Corporation (Jefferson City, MO)
- …+ Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. + Conduct regular ... expansion as appropriate. + Assists in the development and implementation of physician education with respect to clinical issues and policies. + Identifies… more
- University of Utah (Salt Lake City, UT)
- …and to execute any documents necessary to affect their participation as a Medicare and Medicaid participating physician and as a participating provider under ... revocation. -Optometrist must meet all the qualifications to participate in the Medicare and Medicaid programs or any similar government-funded health care program… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Nurse Practitioner or Physician Assistant will be responsible for providing obstetrical and gynecological patient care within the scope and ... within a supervising practice agreement established with a specific physician on the staff of the Department of OB...consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or… more
- Catholic Health Initiatives (Omaha, NE)
- …Message from Medicare (HINN). Discuss the case with the attending physician and if additional clinical information is not available, coordinate the process with ... **Responsibilities** ** Physician Advisor** **Location: Lakeside and Midlands Hospital** **The...strategic planning of the organization. + Build strategies for Medicare important message compliance in collaboration with care management.… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Physician Advisor (PA-Utilization Management) serves as the physician leader in matters ... and Skills** + Member of (1) American College of Physician Advisors (ACPA) or (2) Board Certification by the...levels of care, coding), MCG / InterQual screening criteria, Medicare / Medicaid compliance, medical staff structure, policies and… more
- CenterWell (Tallahassee, FL)
- …us put health first** We are excited to offer the role of Virtual Physician for a new virtual care delivery group within CenterWell Senior Primary Care, Humana's ... patients as seamless as possible. Responsibilities: * Act as a collaborating physician for several nurse practitioners or physician assistants, including… more
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