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Attain Mechanical Inspector and Plans Examiner certification form the Dade County Board of Rules and Appeals within ninety (90) days of appointment. Attain Mechanical Inspector and Plans Examiner certification form the Dade County Board of Rules and Appeals within ninety (90) days of appointment.
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The Program Manager is a key member of the Medicare Advantage Claims, Configuration and Appeals and Grievance Operations team. Assists in planning, developing, implementing, and managing the Medicare Advantage Claims, Appeals and Grievance program requirements, operational initiatives and policies.
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Experience in Medicare Advantage Claims, Appeals & Grievances, program/project management. The Program Manager leads and manages key operational programs, initiatives and strategic projects that span across the functional teams of Claims, Configuration and Appeals and Grievances.
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Along with the Assistant Director, Medicare Advantage Operations, the Program Manager is responsible for program management activities impacting the functional areas within the span of control of the Assistant Director including but not limited to initiation, planning, development, and monitoring of program implementations and day to day operations performance monitoring in order to ensure timeliness and compliance.
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The incumbent reviews and analyzes key program, regulatory and operational performance indicators for the functional areas reporting to the Assistant Director, Medicare Advantage Operations and makes recommendations to the leadership team on strategies to improve performance.
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Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished Medicare Program Manager. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients businesses forward.
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Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. May also engage in grievance and appeals reviews.
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Experience with Microsoft Office Suite (Excel, Word, and PowerPoint) and data visualization tools. Program Manager, Medicare Advantage Operations. Must have at least 3-4 years of managing projects or programs in a healthcare or ACO environment.
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Knowledge of all payors insurance; self-pay after insurance, reimbursements, collections, appeals, claims follow-up and third party billing, required. Manage claim details and verify accurate reimbursement, so as to initiate account adjustments and/or appeals on payment disputes.
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Amerit Consulting is an extremely fast-growing staffing and consulting firm. Bachelors Degree in Business Administration, Health Care or other related field or equivalent work experience preferred. Must have knowledge and experience in project management, health plan operations, data analysis, and strong organizational, communication and leadership skills.
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Experience with national guidelines such as MCG or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialization + Advanced degree such as an MBA, MHA, or MPH + Exposure to Public Health principles, Population Health, analytics, and use of business metrics.
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Lead Technical Recruiter. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally, as well as small to mid-sized organizations on a local & regional level.
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Must be admitted to practice law in Florida and be a member of the Florida Bar. Must be admitted to practice before the U.S. District Court, Middle District of Florida, and U.S. Circuit Court of Appeals, 11th Circuit, within six (6) months of hiring.
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Job Description: Appeals Coordinator (Hybrid Position)Our client, a leading company specializing in non-invasive skin cancer treatment, is seeking an experienced and detail-oriented Appeals Coordinator to join their team.
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File appeals for denied claims and follow-up as necessary through appeal resolution. Emerus leading national health system partners include Allegheny Health Network, Ascension, Baptist Health System, Baylor, Scott & White Health, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS and MultiCare.
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