- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Manager , Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with ... risk by upholding compliance standards. Under limited supervision from the Manager , Revenue Integrity or other more senior Revenue Integrity leaders, the… more
- State of Colorado (Pueblo, CO)
- …nursing staff efficiency. Oversee the attainment and achievement of Unit/ Program /Hospital/Nursing Department goals for the specified shift. Primary duties consist ... coordination and timely statistical reporting of incidents, acuity, QA/PI activities, implementation of department policies and standards of care, responsible for… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services (CMCS), Office of ... to include: (1) Independently researches and analyzes national health insurance program policy issues to advise leadership, to provide technical assistance, or… more
- CVS Health (Richmond, VA)
- …Fully Integrated Dual Eligible Plan (FIDE) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. ... complex, and vulnerable members-those enrolled in HIDE/FIDE SNP and other Medicaid waiver programs-experience safe, effective, and seamless transitions across care… more
- Aveanna Healthcare (Great Barrington, MA)
- …disabilities and complex medical needs.Direct Support Professional will oversee the implementation of a behavior management systems and supports. This position ... Plan). Immediately reports any changes or problems in the Individuals condition to manager . Required to complete all documentation in accordance with state and … more
- First Atlantic Health Care (Saco, ME)
- …Healthcare, part of the Atlantic Heights Community, is a fully-licensed Medicaid /Medicare-certified facility offering 105 beds. Under the ownership of First Atlantic ... on an individual basis. This position reports to the Social Services Director/ Manager . Essential Job Functions: This facility expects their employees to promote an… more
- Commonwealth Care Alliance (Boston, MA)
- …Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory ... and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. * Lead initiatives to streamline provider… more
- Molina Healthcare (Fort Worth, TX)
- …services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality ... utilization and effective resource management. * Assumes leadership relative to knowledge, implementation , training, and supervision of the use of the criteria for… more
- Humana (Concord, NH)
- …Capacity Management - provide value-based guidance on backlog prioritization to the implementation team. Coordinate with the Product Manager and set boundaries ... the overall set of features prioritized by the Product Manager . Additionally provide clarity to scrum team members with...+ Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development… more
- Waystar (Louisville, KY)
- …software. This role will be responsible for working with the Systems Engineering Manager to design, develop, configure, and document existing, as well as new, ... continually changing SaaS datacenter environment + Works with the Systems Engineering Manager on new projects that arise from business needs + Creates documentation… more