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Ability to read and interpret documents such as Medicare, Medicaid and commercial health plan policy articles and procedure manuals. Knowledge of Medicare, Medicaid, and commercial health plan reimbursement methodologies and documentation requirements.
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Foster state relationships for DSNP, in partnership with the Medicaid President, LTSS leader, and Government Relations. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
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Accurately processes and bills Medicare, Medicaid, private payer and patient claims in accordance with payer requirements and organization policy. Athena Health Care Systems and its managed centers follow federal and state mandatory guidelines regarding staff vaccinations; our vaccination policy requires all newly hired staff, regardless of position or work location, to be fully vaccinated against COVID-19 unless they receive an approved exemption from Athena, except where prohibited by state law.
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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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The Intake Coordinator is responsible for completing and documenting all initial in-home 100.2 assessments (functional needs assessment), Medicaid application, Arbor Review Group (ARG) applications and all corresponding applications for Long Term Care Medicaid waiver services on the individual's behalf in compliance with the rules and regulations set for by Health Care Policy and Financing (HCPF.
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Extensive knowledge of Medicare payment policy, Medicare Advantage, and/or Medicaid. We advance evidence in the areas of education, health, the workforce, human services, and international development to create a better, more equitable world.
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The ideal candidate will have experience in growing Medicaid markets, including but not limited to cross functional expertise in marketing/advertising, program management, business development, sales, health policy, and strategic operations.
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See Lifepoint Health Terms & Conditions at and Privacy Policy at and SonicJobs Privacy Policy at and Terms of Use at. 1) Practice is consistently current and in accordance with policies and procedures, professional practice standards, State Practice Act/Rules and Regulations (e.g. Arkansas State Board of Nursing, American Nurses Association, Code of Ethics for Nursing and regulatory bodies such as the Joint Commission and Centers for Medicare and Medicaid.
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Follow patients through the entire course of treatment, whether inpatient, outpatient, or in the community and provide them the education they need; provide service coordination and linkage, including benefits (i.e., SSI, Medicaid), housing, health care, social and behavioral health services, and all other necessary services; provide prevention, intervention, and development of a crisis plan with patients; assist patients with setting up transportation.
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Ph. D in Economics, Health Services Research, or a related field with a minimum of 7 years of relevant work experience managing and conducting research or related work or Masters degree and at least 11 years of relevant experience.
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Our current work focuses specifically on the low-income older adults and people with disabilities who are enrolled in Medicare and Medicaid and uses policy change in those programs to create more coordinated, high quality, and affordable care.
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Serve in project director role for CMS-funded projects focused on Medicare policy, oversight, and program operations with particular focus on post-acute care settings and programs including, but not limited to: home health, hospice, skilled nursing, inpatient rehabilitation, long-term care hospitals and inpatient psychiatric care.
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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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Health services research, such as healthcare quality, Medicaid eligibility, Medicaid/Medicare claims, health disparities, or chronic diseases. In collaboration with the Director of Research and Evaluation, the Assistant Director of Analytics, principal investigators, and other ACHI staff, the Senior Data Analyst will develop and implement advanced data and statistical analytics using private and public healthcare claims data and other health data to inform research on important health policy questions, as well as cost and quality comparative studies for the State of Arkansas.
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Required Education and Experience Master’s Degree in computer science, applied/computational mathematics, engineering, biostatistics, statistics, or a quantitative field such as astronomy or geology, economics, health policy, health services research, public policy, or a related field and two years of experience or an equivalent combination of education and experience.
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