- UpvoteDownvoteShare Job
- Suggest Revision
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 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Oversight of Medicaid claims, Tricare and Coverage Gap processing operations with Third Party vendor and coordination of quarterly cash flow monitoring with Treasury. Insure approval workflow of Medicaid, Tricare and Coverage Gap claims follows approval matrix and completes within payment due date cycle.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The QC Supervisor provides on-site programmatic oversight of all federally mandated policy, procedural and programmatic review activities for the Supplemental Nutrition Assistance Program (SNAP) and the Medicaid (MC) Program.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Medicare Advantage and Medicaid (Dual Members) risk adjustment experience preferred. Experience with ACA Risk adjustment, Star, and Medicaid quality incentives preferred. Preferred Location: Hanover, MD.The Medicare Risk Adjustment Advanced Analytic Senior Is responsible for creating statistical models to predict, classify, quantify, and/or forecast business metrics.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Customizes the PRA for pediatric clinical research studies, utilizing Medicaid, Georgia statutes, and/or other reliable sources. Applies the Centers for Medicare & Medicaid National Coverage Determination (NCD) 310.1, Routine Costs in Clinical Trials, to determine if the study is a qualifying clinical trial with therapeutic intent, diagnosed disease, Medicare benefit category, and deemed status or seven desirable characteristics.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Key Responsibilities Utilize knowledge & skills set to accurately complete Medicare, Medi-Cal, Tricare, Champ VA, Medicaid Programs & other non-specific governmental & commercial (BCBS, Aetna, UHC, etc.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
- Suggest Revision
About NYC Health + Hospitals 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.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
You should have an understanding of regulations impacting digital products such as FCC (TCPA, CANSPAM), FTC, State Unfair Competition Laws; familiarity with EEOC/ADA/GINA, ERISA, HIPAA, Medicare/Medicaid a plus.
$180,000 - $210,000 a yearFull-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Serves as a subject matter expert for clinical documentation integrity (CDI), Case Mix Index (CMI) and multiple reimbursement systems (i.e., APR-DRG, Medicare, Medicaid, etc.) Assist with reviews of all Medicare and Medicaid audits including but not limited to RAC, THHS.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Centers for Medicare and Medicaid Services (CMS) rated Stamford Hospital as a five-star hospital for Overall Quality and The Leapfrog Group awarded Stamford Hospital an "A" for patient safety.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive behavior, as well as overpayment recoveries, administrative sanctions, and the referral of suspected fraud or other criminal violations for law enforcement investigation.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. As a n Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
- Suggest Revision
This position requires the successful completion of pre-employment background checks including but not limited to: FBI/Federal Records Check; VA State Child Abuse/Neglect Registry; Medicare/Medicaid Fraud Database; education/certifications; and driver's license.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Adheres to all Corporate and Departmental policies and ensures all regulatory requirements such as DOH, CMS, Medicaid, and accreditation requirements such as NCQA, URAC and HEDIS functionalities are met or exceeded.
ExpandApply NowActive JobUpdated 11 days ago
medicaid job
FEATURED BLOG POSTS
A Potential TikTok Ban?!
As you may already know, there has been a lot of talk lately about the possibility of a TikTok ban. While this has not yet come to fruition, it's important to consider the implications this could have for businesses and recruiters who rely on TikTok as a platform to market their brand, recruit new talent, and connect with their audience.
The Effects of Workplace Racism and Sexism
One day it's a covert statement to a mother returning to work after maternity leave. Another day it's a lingering gaze at an employee enjoying a culturally rich meal. These microaggressions (or sometimes macroaggressions) can take an employee from a confident, high-performer to one that feels insecure being themselves at work. Your employees engage with people with different ideas and feel most comfortable and valued when they can work without losing their cultural, racial, and gender identity. While most employers know this, why have workplace racism and sexism often been neglected?
When Rage Applying Strikes: How to Identify Unserious Candidates
As the job market remains highly competitive, we have seen a surge in "rage applying." This is when candidates apply to multiple jobs, often without considering whether they are truly interested in the role. Rage applying goes hand-in-hand with quiet quitting. Often, employees want to entertain the thoughts and feelings of leaving their job, but they aren't necessarily serious about leaving yet. Meanwhile, other employees engaging in this trend are actually trying to find a better role. As a recruiter, it can be hard to identify who are the real applicants in a sea full of quiet quitters, but understanding rage applying and identifying red flags will certainly help.
How to Increase Job Ad Exposure
In today's competitive job market, writing quality job ads is critical for attracting top talent to your organization. While networking and candidate referrals are prime real estate for finding qualified candidates, nothing beats the tried-and-true method of writing an extraordinary job ad. But while writing a great job ad is the first step, what's more important is increasing visibility. You could have the most detailed, well-written ad on the internet, but if no one sees it, then you are wasting time (and potentially money!). Employers often believe that job boards are the root of the problem, but you can learn how to increase job ad exposure by tweaking a few steps of your recruitment process.
How to Navigate Hiring Out of State
The job market has shifted significantly in recent years. The accelerated adoption of technology has not only pushed many companies into remote working arrangements but also increased the availability of supporting tools and technologies (i.e., video conferencing and collaboration software).
Building a Candidate Pipeline Through Internships
Building a candidate pipeline through a great internship program for local college students and recent graduates at local universities is a great and cost-effective way to attract and retain top talent. By offering meaningful and impactful work experiences, regular feedback, coaching, and mentorship, you can create a positive internship experience that will make your organization a sought-after destination for future employees. This not only benefits the organization in the short-term but also in the long-term, as you'll have a pool of well-trained and experienced candidates who may be interested in full-time employment once they graduate. Furthermore, building relationships with local universities and college students can increase brand awareness and build a positive reputation for your organization in the local community.
Hiring Transparency
Transparency in hiring refers to the open and honest communication and information sharing that takes place between employers and job candidates. It encompasses all aspects of the hiring process, from posting job descriptions to providing feedback on performance during and after the interview process. In today's job market, hiring transparency has become increasingly important for both employers and candidates alike.