- CVS Health (Phoenix, AZ)
- …data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, including ... internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree or equivalent… more
- City and County of San Francisco (San Francisco, CA)
- …meet all of the following criteria: + Be eligible to participate in Medicare , Medicaid, and/or other federal healthcare programs + Possess a National Provider ... + Possess a valid third-party billable provider certification (such as Medicare , Medi-Cal, and/or private insurance) OR have submitted a completed billable… more
- Northwell Health (Lake Success, NY)
- …online resources: Official Coding Guidelines (OCG), AHA Coding Clinic, Center for Medicare Services and CPT Assistant) to identify appropriate codes and reference ... for all records as required and in accordance with the Centers for Medicare and Medicaid Services (CMS) rules and regulations. 7.Make determinations on medical… more
- Molina Healthcare (UT)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... excellent problem-solving skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting,… more
- Datavant (Indianapolis, IN)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic ... or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. +… more
- Providence (Irvine, CA)
- …retain the best people, we must empower them.** **Providence is calling a Senior Manager Contracting who will:** + Be responsible for leading, or participating as ... assigned + Be responsible for revenue primarily associated with Commercial, Medicare Advantage, and managed Medicaid products + Develop complex negotiation… more
- Cardinal Health (Denver, CO)
- ** Senior Coordinator, Individualized Care (Case Manager)** Cardinal Health Sonexus (TM) Access and Patient Support helps specialty pharmaceutical manufacturers ... * Pharmacy benefits management experience preferred with specific knowledge of Medicare , Medicaid and commercially insured payer common practices and policies,… more
- Akumin (Miami, FL)
- The ** Senior ** **Director of Operations** manages the daily operations, and planning the use of materials and human resources. Provide leadership and individual ... adaptability and ability to manage change. + Knowledge of Workers' Compensation, Medicare and/or clinical standards of practice, preferred. + Prior experience in an… more
- Weill Cornell Medical College (New York, NY)
- Title: Senior Patient Coordinator Location: Upper East Side Org Unit: Otolaryngology Head and Neck Surgery Work Days: Monday-Friday Weekly Hours: 35.00 Exemption ... coding. + Working knowledge of third party payor reimbursement - Medicare , Medicaid, Managed Care and commercial insurance. **Licenses and Certifications** **Working… more
- Weill Cornell Medical College (New York, NY)
- Title: Senior Medical Secretary Location: Upper East Side Org Unit: Burn Surgery Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: Non-Exempt Salary ... coding. + Working knowledge of third party payor reimbursement - Medicare , Medicaid, Managed Care and commercial insurance. **Licenses and Certifications** **Working… more