- Centene Corporation (Charlotte, NC)
- …care management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform home and/or other site visits to assess ... member's needs and collaborate with healthcare providers and partners + Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare… more
- Banner Health (Tucson, AZ)
- …care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the clinical quality of Care ... Coordination services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care. The goal is to empower the patient and the family to participate to the fullest of their abilities in the discharge planning… more
- Baylor Scott & White Health (Fort Worth, TX)
- …post-acute partners, payers). Prepare exec-ready summaries for productivity, cost initiatives, payer mix, and growth KPIs. **Board, Medical Staff, and Governance ... Support** Own timelines, drafting, and quality control for board/committee agendas, decks, and packets. Coordinate medical staff, quality, finance, and ethics committees, record minutes and track action items to closure. Provide status updates and decision… more
- Honor Community Health (Pontiac, MI)
- …essential functions. The Insurance Verification Coordinator position requires fundamental knowledge of payer portals and navigation. What are we looking for? + ) ... High school diploma or equivalent is required. + Experience working in a healthcare setting strongly preferred + Strong computer skills, including knowledge of Microsoft Office + Experience in using Electronic Medical Records preferred. + A flexible and… more
- University of Colorado (Denver, CO)
- …Clinic program.** Ensure accurate managing and tracking of referrals; insurance/ payer verification; scheduling and appointment management; billing and financial ... tracking; medical records management in electronic medical records system; and creating, maintaining, and running reports. Provide clear expectations and instructions and ensure follow-through of clinic staff in previously listed tasks. **Design and implement… more
- HCA Healthcare (Asheville, NC)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care ... concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or psychosocial needs. + You… more
- HCA Healthcare (Margate, FL)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care ... concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or psychosocial needs. + You… more
- Seattle Children's (Seattle, WA)
- …board level meetings, large group training, and in interactions with the payer community. This position develops goals, plans, and metrics, ensuring effective ... communication and implementation of initiatives. Represent the Professional Compliance Officer as needed. SERIES CONCEPT: A program is a specialized area with specific complex components and discrete tasks which distinguish it from the main body of the… more
- Lilly (Indianapolis, IN)
- …use of real world evidence to support provider, patient, policy and payer needs. **Minimum Qualification Requirements:** + Medical Doctor or Doctor of Osteopathy. ... Must be board eligible or certified in appropriate specialty/subspecialty or have completed the comparable level of post-medical school clinical training relevant to the country of hiring. US trained physicians must have achieved board eligibility or… more
- BJC HealthCare (St. Louis, MO)
- …systems. Demonstrates ability to understand and comply with Medicare Secondary Payer , HIPAA privacy standards, Patient Bill of Rights and Responsibilities, Advance ... Directives, Consent to Treat, EMTALA, and JCAHO requirements. Ensures updates regarding changes to operational procedures are communicated to the staff. Performs visual quality audits and reports results to leadership. May participate in the development of… more
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