- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- OhioHealth (Columbus, OH)
- …This position will be responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is ... projects as assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining...Hospice. Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement . Provide… more
- University of Rochester (Canandaigua, NY)
- …and addressing consequential barriers to securing public benefits which may impact hospital reimbursement and timely discharge. + Possesses a nuanced ... Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States of America) Range: UR… more
- Geisinger (Danville, PA)
- …have a strong understanding of Medicare settlement processes, compliance requirements, and hospital reimbursement regulations. This role requires the ability to ... Summary We are seeking a detail-oriented professional with expertise in Medicare and Pennsylvania Medicaid cost reporting to join our team. The ideal candidate will… more
- Omaha Children's Hospital (Omaha, NE)
- …including knowledge of CPT, HCPCS and revenue codes and their effect on hospital reimbursement . Knowledge of the current healthcare climate, including managed ... and education. As the state's only full-service pediatric healthcare center, we provide comprehensive, holistic care to our patients and families-from primary and… more
- AmeriHealth Caritas (Washington, DC)
- …dual eligibility health insurance, ACA Exchange Business & DSNPs. + 5 years provider contracting/ reimbursement experience in healthcare setting. + 3 years of ... Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. This position is also responsible… more
- Omaha Children's Hospital (Omaha, NE)
- …methodologies + Conducts research on Federal and State regulations/laws + Coordinates regulatory reimbursement audits of the hospital and represents the System * ... and education. As the state's only full-service pediatric healthcare center, we provide comprehensive, holistic care to our patients and families-from primary and… more
- AmeriHealth Caritas (Southfield, MI)
- …partnership with & incentives for providers. + Ensure strategic alignment with state Medicaid agenda and compliance with provider related aspects of state ... preferred. + 10 or more years of experience years of managed care provider contracting and reimbursement experience, including in-depth knowledge of … more
- WellSense (MA)
- …Responsible for managing the assigned territory of professional, institutional and ancillary provider types in order to enhance these relationships so that Well ... Serves as the primary liaison between WellSense Health Plan ("Plan") and key provider organizations, taking the lead and promoting collaboration within Plan, as it… more
- Commonwealth Care Alliance (Boston, MA)
- …teams to monitor network performance against internal and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA ... 011230 CA- Provider Engagement & Performance Position Summary: The Director...contracting, or population health initiatives. * Prior work with hospital systems, large medical groups, and specialty care networks.… more