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Risk bearing entities include, but are not limited to, the following: Health Plans, Pharmacy Benefit Managers (PBM), Third Party Administrators (TPA) and Accountable Care Organizations (ACO). The Regional Vice President, Sales will be responsible for generating sales from new logos and existing customers for the company.
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Per the ACA, employees working 30 Plus hours per week are eligible to enroll in one of the two 2 medical plan options - HRA & ACO. Enjoy headliner concert and theatre productions, professional hockey events, endless community recreation and open space opportunities, art and sculpture shows, and several local festivals.
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Work closely with ACO teams to develop intervention plans and review KPIs. Assist in building strategic partnerships. Your Footprint: Lead clinical engagement in each quality program served, partnering with the clinical team and practice transformation team to drive performance improvement in value-based care within each participating practice in Vandalia Health Network.
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Coordinate for sourcing of operational system data (e.g. mapping and imagery data, ATO/ACO databases, etc.) The Air Operations Center Subject Matter Expert Site Manager / Configuration Manager (CM) will support the 612th Air Operations Center (AOC) at Davis-Monthan AFB, AZ. The contract CM WSM shall assist the WSM and in his/her absence, help manage the health, welfare, and setup of all AOC systems in direct support to the AOC Director.
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We have partnered with Aledade ACO to provide additional structure for measuring and assessing the quality of the care we deliver. We have partnered with Aledade ACO to provide additional structure for measuring and assessing the quality of the care we deliver.
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Merchandiser Retail Coverage II - Walmart - FLOATERGeneral InformationCompany: ACO-USLocation: POTSDAM, New York, 13676Ref #: 69397Pay Rate: $ Experience/skills and/or location may influence position wage rateRange Minimum: $ Range Maximum: $ Function: MerchandisingEmployment Duration: Part-timeDescription and RequirementsAs a Merchandiser Retail Coverage II - Walmart - FLOATER at Acosta, you’ll ensure Acosta’s client brands stand out at Walmart stores by driving product availability.
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Submits claims to Hospice Area Executive of Operations (ACO) and assures that the ACO has signed off on claims before sending them to the appropriate accounts payable regional mailbox; sends claims a minimum of once per week.
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Healthcare Domain Knowledge: Conceptual understanding of how hospitals and systems work, how theyre paid by commercial carriers and the government, and how changing reimbursement is necessitating that hospitals and health systems be able to identify and manage risk; be able to decipher the healthcare-alphabet-soup that includes ACA, ACO, AMA, BMI, CMS, through to HIE and HIPAA, etc.
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Experience and proven understanding and use of sales methodologies aimed at closing complex sales (e.g., Miller-Heiman's Strategic Selling, Solution Selling, The Challenger Sales, etc.) Broad understanding of the health care regulations affecting risk-bearing entities (e.g., CMS compliance, STARS, NCQA, etc.
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We are seeking a dynamic and skilled Actuarial Workflow Lead to spearhead our efforts in supporting ACO REACH & MSSP performance evaluation and forecasting, as well as leading value-based contracting (VBC) workflows.
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Working knowledge of the CMMI Direct Contracting or Accountable Care Organization (ACO) program(s) Support the Government Programs & Provider Risk Actuarial Models teams development of actuarial models to be used for medical expense and trend analysis and forecasting, provider risk contract evaluation, and ACO REACH / MSSP performance evaluation.
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The Senior Actuarial Consultant will lead actuarial workflows in support of ACO REACH & MSSP performance evaluation and forecasting. 2+ years working with a CMMI ACO Model (of any kind) is strongly preferred.
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Lead provider risk contract evaluations and ACO REACH / MSSP performance evaluations, interfacing with internal NeueHealth team and external consulting actuaries. Lead the evaluation of financial implications of provider participation in networks for ACO REACH / MSSP opportunities.
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Experience in quality, care coordination, utilization management in an inpatient, ACO or FQHC environment. Experience in quality, care coordination, utilization management in an inpatient, ACO or FQHC environment.
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This position may be field-based or based at one of MHK's offices in Tampa, FL or Madison, CT; if not based in one of MHK's offices, candidates must have experience working remotely and proven ability to succeed working in a remote model.
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