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Working knowledge in any of the following areas: Medicare Advantage, Medicare Shared Savings Program (MSSP), Managed Medicaid and DSRIP, Commercial HIX, managed care regulations, quality reporting, care management, population management, ACO strategy implementation and operations, and supporting providers in risk-based contracts.
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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. Reporting to the Managing/Senior Corporate Counsel, this role will round out a dynamic and growing legal team, serving as subject matter expert for drafting, reviewing, and negotiating various strategic agreements and complex transactions.
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Regulatory Compliance: Stay abreast of evolving regulatory requirements related to program offerings (Medicare Advantage, ACO REACH, etc),population health management and value-based care, ensuring compliance with relevant laws and regulations.
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Educate providers on risk adjustment: its purpose, CMS-HCC coding rules and guidelines, open condition reporting, identifying unreported conditions, proper documentation for MA, MSSP, ACO Reach, and DCE patients.
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4+ years of healthcare experience, including experience in an ACO or managed care setting. CMS audits and regulatory reporting experience. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life.
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Under the direction of the IT Applications Leadership, this position has responsibility for the development, maintenance, integration, data governance and data reporting of the hospital's business systems.
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Quality Coordinator is the internal resource for quality reporting, quality processes, HEDIS and Health plan quality metrics and quality incentive programs such as HCC, STAR, P4P, NCQA and ACO. This role has expertise of extracting and analyzing quality data from the electronic medical record.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Provides cross-functional support to develop of operational and performance reporting. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine.
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Acts as a key member of the team and is instrumental in creating a scalable, high-quality partnership model responsible for delivering sustainable population health outcomes in collaboration with health systems, payers, and providers.
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This role may also be eligible for incentive compensation. Once you create the account, you may apply to any position you feel is a good fit without having to re-enter information. Provides support to the team as it relates to execution of assigned operational workstreams (Provider Engagement, Care Management, etc.
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At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Participates in cross-market discussions to identify opportunities to deploy or export newly identified best practices.
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Strategic and entrepreneurial outlook with strong collaboration skills. 3+ years of client facing experience within the healthcare domain or the knowledge, skills, and abilities to succeed in the role.
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Ample experience working with health systems in strategy, operations, or finance. Strong client-facing and interpersonal skills with the ability to foster relationships. Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person.
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Keeps abreast of current industry, market and policy landscape. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more.
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Collaborates with internal teams to identify opportunities for improvement of our overall operating model. Facilitates internal account governance, especially team meetings. Participates in key client meetings, including payer operating committees and provider performance meetings.
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Whether you’re applying for your first job or looking to move up the career ladder, personality tests aren’t usually the first thing we think about. But surprisingly, they can have a massive impact on how our future employers perceive us. In fact, a 2017 study by the Society for Human Resource Management (SHRM) has found that 32% of U.S. employers use personality tests when hiring for senior management positions, and 28% use them for middle management positions. Personality tests are also used for hourly workers and contractors, though less frequently.
Virtual Reality Job Interviews
With the advent of desktop computers, the arduous task of scouring through weekly job classifieds became a thing of the past. The mid-1990s brought about a new era where job seekers could easily search and apply for jobs online. The introduction of AOL's Instant Messaging feature provided an even faster means for employers and candidates to communicate and schedule interviews. As smartphones became more pervasive in the early 2000s, hiring managers increasingly used phone calls for screening and interviewing candidates. Despite this trend, over 80% of interviews still took place in person.
A Potential TikTok Ban?!
As you may already know, there has been a lot of talk lately about the possibility of a TikTok ban. While this has not yet come to fruition, it's important to consider the implications this could have for businesses and recruiters who rely on TikTok as a platform to market their brand, recruit new talent, and connect with their audience.
The Effects of Workplace Racism and Sexism
One day it's a covert statement to a mother returning to work after maternity leave. Another day it's a lingering gaze at an employee enjoying a culturally rich meal. These microaggressions (or sometimes macroaggressions) can take an employee from a confident, high-performer to one that feels insecure being themselves at work. Your employees engage with people with different ideas and feel most comfortable and valued when they can work without losing their cultural, racial, and gender identity. While most employers know this, why have workplace racism and sexism often been neglected?
When Rage Applying Strikes: How to Identify Unserious Candidates
As the job market remains highly competitive, we have seen a surge in "rage applying." This is when candidates apply to multiple jobs, often without considering whether they are truly interested in the role. Rage applying goes hand-in-hand with quiet quitting. Often, employees want to entertain the thoughts and feelings of leaving their job, but they aren't necessarily serious about leaving yet. Meanwhile, other employees engaging in this trend are actually trying to find a better role. As a recruiter, it can be hard to identify who are the real applicants in a sea full of quiet quitters, but understanding rage applying and identifying red flags will certainly help.
How to Increase Job Ad Exposure
In today's competitive job market, writing quality job ads is critical for attracting top talent to your organization. While networking and candidate referrals are prime real estate for finding qualified candidates, nothing beats the tried-and-true method of writing an extraordinary job ad. But while writing a great job ad is the first step, what's more important is increasing visibility. You could have the most detailed, well-written ad on the internet, but if no one sees it, then you are wasting time (and potentially money!). Employers often believe that job boards are the root of the problem, but you can learn how to increase job ad exposure by tweaking a few steps of your recruitment process.