• Clinical Documentation Integrity Specialist…

    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
    UCLA Health (05/16/25)
    - Related Jobs
  • Medical Director ( Medicare )

    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
    Molina Healthcare (05/02/25)
    - Related Jobs
  • Medicare Marketing Coordinator

    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
    BayCare Health System (04/18/25)
    - Related Jobs
  • Medicare Behavioral Health Case Manager…

    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
    Fallon Health (04/16/25)
    - Related Jobs
  • Remote Medicare Medical Director

    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
    Centene Corporation (05/18/25)
    - Related Jobs
  • Clinical Optometrist

    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
    University of Utah (05/02/25)
    - Related Jobs
  • Nurse Practitioner/ Physician Assistant 2nd…

    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
    SUNY Upstate Medical University (04/16/25)
    - Related Jobs
  • Physician Advisor

    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
    Catholic Health Initiatives (04/21/25)
    - Related Jobs
  • Physician Advisor - Utilization Management…

    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
    Ochsner Health (04/09/25)
    - Related Jobs
  • Physician -Florida

    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
    CenterWell (05/22/25)
    - Related Jobs