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Health care regulatory knowledge focusing on Fraud, Waste, and Abuse; knowledge of Value-based care, Medicare Advantage Organizations, ACO REACH and MSSP programs is required. This role will provide regulatory guidance on various healthcare-related issues with a focus on Anti-kickback Statute (and related state statutes), Stark Law, Civil Monetary Penalties Law, and develop compliant solutions to to facilitate and promote One Medical's business objectives, including value-based care, care coordination, and health system affiliations.
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At least 2 years of experience in case management for value-based care (health plan, delegated provider group, ACO, etc.) Under this value-based care model, CareConnectMD DCE will deliver care coordination services in close collaboration with primary care physicians, specialists, and advanced practice professionals in California, Georgia, Ohio, Indiana, Texas, as well as other expansion locations.
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The role of the Long Term Services and Supports (LTSS) Care Coordinator is to provide LTSS care planning, care team participation, LTSS coordination, and support transitions of care, provide health and wellness coaching, and connect Boston Allied Partners members with social services and community resources.
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As the first Accountable Care Organization (ACO) accredited by Medicare in Utah, and the only Next Generation ACO in the state, Revere Health offers a unique, patient-oriented approach to healthcare.
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The Care Coordinator is responsible for promoting coordination in the delivery and receipt of LTSS to enrollees assigned by Accountable Care Organizations (ACO) and Managed Care Organizations (MCO.
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Its network of more than 3,000 physicians, serving more than 355,000 HMO, ACO and PPO patients, is dedicated to improving care and reducing costs through innovative care management and care coordination programs, use of health care technology, and population health management strategies.
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The Clinical Care Manager (CCM) provides intensive care coordination and clinical care management for MassHealth Members with complex medical and behavioral health needs who are enrolled in an Accountable Care Organization (ACO) or Managed Care Organization (MCO) plan.
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Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
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Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
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Manages and coordinates patient care within an ACO environment to help facilitate patient outcomes through in network care coordination. Participates as part of the multi-disciplinary health care team to develop safe and timely coordination of care including but not limited to post-acute placement, palliative/hospice service lines, medical equipment, home healthcare, outpatient follow up, mental health resources, and other community resources.
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The role will collaborate closely with the Primary Care ICCE, Ambulatory Primary Care, Population Health Leadership in all MUSC Divisions, as well as MUSC Inpatient Case Management, ED, Post-Acute Care, Social Work, Community Health Workers, and Specialty Care teams, to ensure alignment and coordination of care coordination programs and services across the continuum for high-risk, high-utilizer patients and MUSC patients in value-based programs.
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Description POSITION SUMMARYCare Coordinators are responsible for the provision of patient visits through; 1) Care coordination and case management, 2) Ensures each patient receives an exceptional experience via quality customer service, 3) Supports anything and everything related to the patient’s experience, including communicating with Referral Coordinators, supporting the Physician Liaison Division and providing quality intake and surveys.
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Works with regional, market, and care site leadership teams to ensure seamless and cost-effective coordination between ambulatory clinics and inpatient services, as well as to support the CIN/ACO and to inform provider recruitment and retention strategies.
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In close partnership with payor partners, care coordination, quality programs, the VBC analytics specialist will design, develop, and optimize reports that leverage multi-source payor portals and provider data to help guide strategy, operations, and clinical initiatives.
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This position is responsible for the assessment, care planning and coordination of care and evaluation of services for Medicare Beneficiaries aligned with the High Needs ACO with CareConnectMD. Patient’s wishes are aligned and known to team.
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