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This position will lead analysis of housing supportive services and care management activities reimbursable by Medi-Cal managed care (i.e. under California’s “CalAIM” program), including the study and analysis of service costs for development of capitation and fee-for-service (FFS) rates.
$47.6 - $68.67 an hourExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Does your Account Management experience include PBM Fee For Service (FFS) services? Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
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Minimum of three (3) years of account management experience for a government or private sector client in health care with two (2) years of Pharmacy claims processing point of sale (POS)systems experience.
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Build deal models for institutional, health plan, and provider contract negotiations, including Medicare Advantage, Commercial Risk, Medi-Cal, and Fee-for-Service. Use data tools (e.g. SQL, Excel) for tracking, analyzing, forecasting and reporting on payors & hospitals financial impact.
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Identify cost-of-care savings opportunities by analyzing physician authorizing/billing patterns in relation to hospital admissions, emergency room visits, office visits, referral practices, and specialty care procedures and provide suggestions for vendor contract changes that can result in cost savings.
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Working knowledge of healthcare pricing and reimbursement methodologies for Medicare, Medicaid/Medi-Cal (CPT/HCPCS, DRG, etc.) Mine data to discover key analytical insights for decision support, with a focus on evaluating & improving financial and operational performance on our health plan and institutional contracts.
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Weekly & monthly sales reports)Prepare monthly and quarterly Brand Revenue schedules such as net sales reports to facilitate Financial ReportingReconcile Brand Fee for Service invoices, coordinate approval and credit memo issuanceCoordinate approval of Commercial invoices and payment processingAssists department with mandatory government reporting including, but not limited to government pricing, etc., as needed.
$45 an hourExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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We are looking for a full-timeManager, Medical Economicsto join our fast-growing team in Los Angeles (hybrid work schedule). If you require assistance in applying for open positions due to a disability, please email us at.
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Strong problem-solving, troubleshooting, and analytical skills with demonstrated ability to develop new reporting and insights using complex data environments. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner.
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The total compensation target pay range for this role is: $110,000 to $135,000. Maintain and improve existing reporting infrastructure to support a variety of internal stakeholders from other teams.
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This role is central to all client Medicaid revenue streams, including Medicaid Administrative Claiming, Cost Reporting and Fee-For-Service EDI transactions. Reporting to the Senior EDI Analyst, Team Lead, the Medicaid Financial Analyst is a trusted partner to Frontline Educations Service Management and Medicaid clients.
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Engenuity is a $15M business comprised of incubations that engage the private sector in public good collaboration such as the Center for Threat Informed Defense (cyber alliance), MITRE ATT&CK Evaluations (fee for service with the cyber vendor community), Open Generation (5G alliance), the Semiconductor Alliance (CHIPS industry collaboration), plus the opportunity to launch spin outs (e.g. MAD20 Training and Certification program launched in 2023.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Prior experience in an analytical/reporting role developing financial and operational models. The salary range represents our national target range for this role. Bachelor's degree in quantitative field such as finance, statistics, economics, math or engineering is preferred; Masters degree (MBA, MHA, MPH) is preferred.
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As such, FCS is a fee-for-service program funded by a Medicaid Third Party Administrator, and subject to federal and state reporting requirements. Provide cross-system troubleshooting and consultation with clinical staff, health care clinics, social service providers, housing and shelter staff and all other systems as needed for service development, community planning and resource linkages.
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If you need a reasonable accommodation for any part of the employment process, please email our HR Service Center at. The team is in the midst of a multi-year transformation that will migrate all clients to the best-in-class Oracle Revenue Management and Billing (ORMB) platform that will improve client experience, deliver enhanced controls, optimize workflow, and enable advanced reporting and data analytics.
Full-timeExpandApply NowActive JobUpdated 2 days ago
fee for service reporting jobs
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