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Maintain accreditation and licensure standards of The Joint Commission (TJC) on accreditation of hospital organizations, Medicare, Medicaid, state licensure, regulatory agencies, and similar organizations.
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Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care preferred. The Program Manager is responsible for conducting clinical audits of the providers to ensure excellent service deliver, and that care is administered in accordance with Medicare, Medicare Advantage, and all other compliance programs, state laws and regulatory compliance, privacy and security, detecting, preventing, and correcting fraud, waste, and abuse.
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Subject matter expertise in healthcare claims data preferred, and even better with experience in HEDIS, quality reporting, clinical (EMR/EHR; Epic) or enrollment/membership data; experience with Medicare and Medicaid data is a plus.
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If appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a National Provider Identifier (NPI) number issued by the National Plan and Provider Enumeration System (NPPES); and otherwise actively participate to the degree necessary to allow for your services to be billed through Medicare and Medicaid.
Starting at $63,108 - $80,248 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Current and unrestricted license to practice in the Commonwealth of Virginia, to include LCSW or LPC, with preference given to LCSW. Cannot be sanctioned under Medicaid or Medicare. Current and unrestricted license to practice in the Commonwealth of Virginia, to include LCSW or LPC, with preference given to LCSW. Cannot be sanctioned under Medicaid or Medicare.
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Many of our skilled nursing facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Signature HealthCARE is a family-based healthcare company that offers integrated services in 7 states across the continuum of care: skilled nursing, rehabilitation, assisted living, memory care, home health, cognitive care, and telemedicine.
Up to $21.94 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required. Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required.
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Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. View our Equity and Inclusion Statement here.
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A growing number of Signature centers are earning Five-Star ratings from the Centers for Medicare & Medicaid Services. To learn more about our benefits offered, please contact Jenny Collins, Senior Director of Talent Acquisition, directly at (561) 234-0371 or jcollins@signaturehealthcarellc.com.
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You will also support patients and providers regarding Medicare and Medicaid eligibility and benefits year-round, but especially during the Open Enrollment season. Grow trusting relationships with patients to understand their needs and appropriately guide their coverage selections and assist in their enrollment for Medicare and Medicaid options.
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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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As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
Full-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Skills: Must be able to secure credentialing through identified agencies (Medicare, Medicaid, etc. Performs clinical services as directed by the CCO. Precepts physician assistant students, nurse practitioner students, and other identified students as requested.
$205,000 - $328,965 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth 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.
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Demonstrated understanding of the application of healthcare finance and academic medicine and demonstrated competence in health care payment models, value-based care models, Centers for Medicare and Medicaid Services, medical billing, accounting, health systems organizational models is also required.
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