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The policy practice focuses on a range of issues including ongoing federal and state discussion around drug pricing policy; Medicare Advantage and Part D policy and payment; evolving benefit designs and coverage in public and private payers; Medicaid; and other state health policies.
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About Us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
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This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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Lead the design of data pipelines and perform analytics involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and HIEs, to effectively answer research questions about health care policy.
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Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual. The PCS Assessor is responsible for the completion of needs-based eligibility determinations for North Carolinians who are applying for these Medicaid-funded personal care services provided in their home or in adult care or supervised living homes.
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Responsibilities: Evaluate and provide feedback to direct care staff (home health aide) in the home per policy. Our RN’s are dedicated to ensuring compliance with the client assessment of need and service plan standards governing the provision of Medicaid Waiver programs.
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Knowledge of occupational health policy and procedure in addition to emergency preparedness/disaster management. Manage the development, implementation and evaluation of the organization's employee health and safety management program, including emergency preparedness, designed to provide a safe working environment consistent with the regulations and standards governing health and safety determined by FRHS, the State of South Dakota, Centers for Medicare & Medicaid Services (CMS) and Occupational Health & Safety Administration (OSHA) and other sanctioned agencies.
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Who we are and what we do:TennCare is Tennessee's managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities.
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Our work yields actionable information to guide decisions in wide-ranging policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development.
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Taos Healthcare - Job Type: Full-time Benefits: Benefits: 401k, Dental, Health, Life & Vision Job Details The MDS Coordinator will be responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, and Federal, State and Certification guidelines, and all other entities as appropriate- Minimum Data Set, discharge and admission tracking, etc.
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Lead the design of data pipelines and perform analytics involving large secondary data sources such as Medicaid (T-MSIS, TAF) administrative claims data to effectively answer research questions and guide decision-making about health care policy.
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Follows and adheres to TRMC vaccine policy(s) mandated by the Centers for Medicare & Medicaid Services (CMS). Working through physician approved protocols, the Advanced Healthcare Practitioner evaluates patients, ensures quality assurance standards are met by following all guidelines of physicians and Titus County Memorial Hospital, and collaborates with physicians and local health care facilities to provide delivery of services available for patients needs.
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Tri-County completes background checks in accordance with Texas State Health and Safety Code, Chapters 250-253: Criminal history check through the Texas Department of Public Safety (TXDPS), Employee Misconduct Registry (EMR), Nurse Aide Registry and for Medicaid and Medicare fraud.
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2+ years of Medicaid experienceincluding PDL and formulary experience with Medicaid UM development and public health policy experience. Medicaid Fee-For-Service experience.
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Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
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