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Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Managed care nurse, managed care rn, nursing, rn, nurse, care management. 1 year of RN experience in managed care, home care, acute care or nursing home preferred.
$90,000 - $110,000 a yearPart-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Working knowledge in any of the following areas: Medicare Advantage, Medicare Shared Savings Program (MSSP), Managed Medicaid and DSRIP, Commercial HIX, managed care regulations, quality reporting, care management, population management, ACO strategy implementation and operations, and supporting providers in risk-based contracts.
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Job DescriptionMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
InternExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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As the Vice President of Payer Contracting Strategy within the Business Development team, you will lead and execute the Company's payer contracting strategy, including, but not limited to, Commercial, Medicare Advantage, and Medicaid plans, and oversee the development of new initiatives to enhance payer value and alignment for value-based care programs.
ExpandApply NowActive JobUpdated 17 days ago - UpvoteDownvoteShare Job
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2 years of progressively responsible experience in a business office or managed care credentialing setting with specific experience in provider enrollment. Provide documentation and prepare reports of provider data necessary for distribution to all payors, including Medicare Advantage and Managed Medicaid.
Full-timeExpandUpdated 5 days ago - UpvoteDownvoteShare Job
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Insurance verification for all payer types: Medicare, Medicaid, Mycare, Managed Care, etc. Candidate must have a working knowledge of Medicare and Medicaid Payers and eligibility within the scope of a Skilled Nursing Facility.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Maintain current knowledge of applicable managed care, Medicare and state Medicaid regulations, reimbursement systems and methodology. Education and/or Experience: RN license in the state Director of Nursing, management or supervisor experience in long-term care, restorative or geriatric nursing.
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MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
$64,579 - $80,723 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Must possess a thorough understanding of Medicare, Medicaid, Private Insurance, Managed Care costing and analysis, personnel management, accounts receivable/collections, resident funds, accounts payable, general ledger, and management of information systems.
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2-3 years managed care setting, medical office or facility setting with demonstration of medical administration duties. Providing referrals for Medicare is a huge PLUS, one of the largest struggles is new hires.
RemoteExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Must have one-year experience in long-term care billing with a working knowledge of Medicare, Medicaid, PPS, Managed Care Organizations, and private insurance. O'Brien Memorial Health Care Center - Masury, OH.
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Acts as an advisor and consultant in the establishment of operational policies of the practice to include: (1) Purchasing and capital allocations; (2) Managed care plan participation; (3) Budget and practice expenses; (4) Medicare/Medicaid participation; (5) Billing and collection of professional fees; (6) Personnel management and related policies; (7) Risk management and quality assurance; and (8) Coding compliance.
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The candidate in this position will provide HEOR & RWE presentations, clinical presentations as necessary, conduct collaborative research, and enter into evidence-based medicine discussions with healthcare providers, RWE researchers, managed markets medical and pharmacy directors, quality improvement specialists, hospital and managed care formulary decision makers and consultant pharmacists, state Medicaid and Medicare decision makers, guideline developers and others.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Reviewing denied/rejected claims from carriers (Medicaid, Medicare, Managed Care, and Commercial insurances) Flagging non-uniform claims including unusual adjustments, denials, fee schedules, etc.
ExpandApply NowActive JobUpdated 4 days ago
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