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Priority areas include Medicare Advantage, Medicare Part D, dual-eligible beneficiaries, Medicaid, primary care, home health care, homelessness, health equity, social determinants of health, among others.
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Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines.
Starting at $161,914.25 - $315,732.79 a year depends on education, experienceFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.
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Overview: VNA Health Group is a premiere Medicare/Medicaid-certified provider of home health , hospice , and community-based services. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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Services are to be provided according to the Texas Resiliency and Recovery Model, and must conform to the Performance Contract, Community Service Standards, and Helen Farabee Centers policy and procedures, and Medicaid standards.
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The ADS Supervisor is responsible for providing oversight of day-to-day administrative processes for the program including assessment processing, supporting case management duties, technical support, and coordinating contracting and coordinationof providers of in-home services to elderly and disabled adult clients receiving Department of Social and Health Services (DSHS) Medicaid funded personal care and other services.
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The Patient Financial Counselor assists patients in resolving the financial responsibility of their healthcare charges through suitable payment arrangements, Medicaid applications, and/or qualifications for financial assistance in accordance with charity care policy and procedure.
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A nurse supervisor shall be a registered nurse with two years’ experience within the last five years in a home health agency, primary care clinic, or health facility, unless the individual has been previously approved for such employment by a program flexibility issued for the individual’s current position at the home health agency prior to April 1, 1995.
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In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
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Be an instrumental part of Corporate Affairs at Humana by assisting in the development of Humana's public policy positions for our public payer businesses with an emphasis on Medicaid, dual eligible policy, and future state public health programs.
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Review healthcare policy (Medicaid manuals, fee schedules, CCI, OIG Alerts, LCAs/LCDs, NCDs, Medicare manuals, etc.) Founded in 2020 and backed by leading investors including Oak HC/FT, F-Prime Capital, Health Velocity Capital and Noro-Moseley Partners, Rialtic's best-in-class payment accuracy product brings programs in-house and helps health insurance companies gain total control over processes that have been managed by disparate and misaligned vendors.
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Exists to manage and enhance computerized claims processing and information management systems in order to assure timely and accurate Medicaid and Child Health Plan Plus (CHP+) claims processing and payments in an environment of rapid policy change.
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The Sterile Processing Tech sorts instruments, assemble and wrap packs house-wide, and reconstruct surgical specialty trays and linen packs according to directions in policy and procedure manual.
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The Policy Analyst – Payment Reform position works in collaboration with the Policy Division and Payment Reform Team to support CHCs in Medicaid and other payment methodologies, including value-based care, and monitors and influences the Colorado Medicaid and behavioral health systems, payment and health system reform and other issues impacting CHCs and their patients.
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At least 15 years of experience working in health research, data analytics, or health policy with a substantial portion of that time related to some aspect of the Medicaid program at the state or federal level.
$150,000 - $200,000 a yearRemoteExpandUpdated 3 days ago
health policy medicaid jobs
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