- UPMC (Pittsburgh, PA)
- …of topics affecting the financial performance of the health plan; assist with reconciling Medicare Advantage Part C and Part D claims data to financials; analyze bid ... changes; develop assumptions, project costs and monitor emerging experience of Medicare Advantage Mandatory Supplemental Benefits including, but not limited to,… more
- Molina Healthcare (Spokane, WA)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …deep knowledge of both government and commercial payment systems; and, (4) Provide Medicare , Medicaid, and payment system expertise in support of BILH provider and ... VP and AVP, the Director will develop long- and short- term Medicare , Medicaid, and other government reimbursement revenue strategies, oversee preparation and… more
- Centene Corporation (Austin, TX)
- …workplace flexibility. **Position Purpose:** Responsible for development and production of Medicare regulatory required materials to ensure compliance with State and ... regulations and alignment with administrative policies. Position supports CNC Medicare Solutions portfolio nationwide with pre-sale and member enrollment materials.… more
- ZOLL Medical Corporation (Broomfield, CO)
- …information systems to collect additional patient and payer demographic information.7) Performs ' Medicare as a Secondary Payor (MSP)' review , coordination of ... appropriate for claims submission and financial reporting.5) Perform in-depth sponsor review investigations to identify, collect, and confirm third party liability… more
- Elevance Health (Manchester, NH)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs. The **Audit and Reimbursement II** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for … more
- Humana (Charleston, WV)
- …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional… more
- General Dynamics Information Technology (Sacramento, CA)
- …None **Job Family:** Project/Task Management **Skills:** Mainframe Computers,Mainframe Legacy Systems, Medicare **Experience:** 10 + years of related experience **Job ... configure, and maintain mainframe operating systems and associated software. + ** Medicare Systems Knowledge:** In-depth understanding of Medicare programs… more
- Goodwin Living (Washington, DC)
- …and rehab MDS coordinator as per policy. Completes all required assessments for Medicare skilled/ Medicare A and Medicare B clients. Communicates and ... summaries per the Rehab Department's policies and procedures and Medicare guidelines. Copies progress note to the IDT record....staff in resident specific programs. + Participates in per review process for yearly ST competencies. + Participates in… more
- New York State Civil Service (Middletown, NY)
- …Credentials will be reviewed at the time of interview.Background Investigation/Justice Center Review : In some agencies, the names of all prospective employees will* ... are responsible for payment of all required fees.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