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We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Oversee facility operations of Patient Access functions (e.g. pre-registration, benefit verification, pre-authorization, admission/registration, service pre-payment, etc.
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Experience with governmental regulatory requirements, inspections, and audits, including but not limited to the federal DHHS Office of Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS), and Office for Civil Rights (OCR), as well as the NYS Office of Medicaid Inspector General (OMIG), NYS Department of Health (DOH), and NYS Office of Mental Health.
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This position is responsible for ensuring the quality of care by monitoring, assessing, and maintaining records regarding the MDS and Care planning process in compliance with the requirements of Medicare and Medicaid and ensuring compliance with PDPM, Medicare Advantage plans, and Medicaid Managed care.
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CHW Certification 1+ years of knowledge of Medicare/Medicaid population Experience & Education Required Minimum Qualifications High School Diploma or GED. At least two years related experience with community engagement and/or health (i.e., medical assistant, classroom assistant, CHW, outreach worker, volunteer, etc.
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Preferred Experience with Medicaid/MassHealth claims billing, Workday Adaptive Insights, and Sage Intacct (GL Package) Preferred Experience with Medicaid/MassHealth claims billing, Workday Adaptive Insights, and Sage Intacct (GL Package.
$52,000 - $55,000 a yearFull-timeExpandUpdated 24 days ago - UpvoteDownvoteShare Job
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Assist in the preparation and drafting of testimony, regulatory comments, and position statements sent to legislative and regulatory bodies and other interested parties concerning legislation, policies, published reports, regulations, and statutes governing Medicaid, long-term services and supports (LTSS), and other waiver programs.
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Minimum of two years of experience of medical billing and coding experience, this should include working AR/Rejections and working with Workers Comp, Auto; Priority Health, BCBS, Medicaid denials is a plus.
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5 or more years' experience in Medicaid, State legislative or executive branch staffer or equivalent experience in Medicaid policy, trade group, law firm, consulting firm, or policy organization.
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8 or more years' experience in Medicaid, State legislative or executive branch staffer or equivalent experience in Medicaid policy, trade group, law firm, consulting firm, or policy organization.
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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 Director of State Public Policy role resides within the Corporate Affairs Department and will serve as an expert in state public payer, Medicaid and dual eligible public policy while working with subject matter experts and business units within the Humana enterprise including our Medicare, Medicaid, and CenterWell businesses.
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Contribute policy expertise to state-level advocacy efforts on public payer issues including Medicaid expansion, integration of the Medicare and Medicaid programs, and state initiatives that affect the role of managed care in Medicaid programs.
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The Director of State Public Policy role resides within the Corporate Affairs Department and will serve as an expert in state public payer, Medicaid and dual eligible public policy while working with subject matter experts and business units within the Humana enterprise.
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Work closely with Humana Medicaid, Medicare, and other lines of business to develop value propositions, white papers and other advocacy materials which support state business development opportunities and operations.
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Maintain current awareness and analyzes/compares trends, positions, and issues promoted by other companies, trade, and advocacy organizations active on Medicaid-related issues. 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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medicaid job
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