- Henry Ford Health System (Troy, MI)
- …medical claims data and managed care membership data. + Knowledge of reimbursement (Commercial, Medicare , Medicaid) methodologies a plus. Additional Information ... GENERAL SUMMARY: The Senior Medical Economic Analyst plays a critical role in analyzing healthcare utilization and medical cost trends to support data driven… more
- Atrius Health (Newton, MA)
- …methodologies . Reviews and monitors contract/payer performance . Compares expected reimbursement data to negotiated rates from contract . Develop analysis in ... . Develop and deploy subject matter expertise in public payer ACO models ( Medicare and Medicaid) and create analyses to assess ACO performance and inform… more
- Sutter Health (Sacramento, CA)
- …+ Understanding of hospital-based outpatient charging and coding + Knowledge of Medicare APC and OPPS reimbursement structures + In-depth knowledge of ... to support accurate charging and coding in compliance with policies. The analyst assists clinical areas to effectively document services and understand the… more
- Centene Corporation (Raleigh, NC)
- …for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to ... leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads the… more
- OhioHealth (Columbus, OH)
- …with principals of chargemaster standardization, governmental and non-governmental reimbursement methodologies, and with awareness of uninsured or non-covered ... federal and state regulatory changes, including those from CMS Centers for Medicare and Medicaid Service s and the American Medical Association. Communicate changes… more
- SSM Health (IL)
- …leading regulatory compliant practices. + Serves as main contact for Medicare Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System ... (OPPS), State Medicare rules and any other documented policies related to...Association (HRMA) + Or + Certified Specialist Payment and Reimbursement (CSPR) - Healthcare Financial Management Association (HRMA) +… more
- UCLA Health (Los Angeles, CA)
- …all this and more at UCLA Health. As a key member of our Medicare Advantage Operations team, you will develop detailed requirements specifications to meet our ... Five or more years of experience managing enrollment, claims, or encounters in a Medicare or managed care environment required + Five or more years of experience… more
- McLaren Health Care (Grand Blanc, MI)
- **Position Summary:** Responsible for compiling complex reimbursement data to support management decision making and internal and external reporting for assigned ... subsidiaries. Assists in coordination of reimbursement functions related to the strategic financial planning process....reviews the schedules required to support the submission of Medicare , Medicaid and Blue Cross cost report, complying with… more
- Huntington Ingalls Industries (Woodlawn, MD)
- …Subject Matter Expert (SME) to support our customer within the Centers for Medicare and Medicaid Services (CMS) effort in Woodlawn, Maryland. This full-time position ... insurance; employee discounts; paid holidays and paid time off; tuition reimbursement ; as well as early childhood and post-secondary education scholarships.… more
- Centene Corporation (Tallahassee, FL)
- …landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: $68,700 -123,700 annual Centene offers a ... including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement , paid time off plus holidays, and a flexible approach to work… more
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