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Pinnacle Home Care is a Medicare Certified and Florida Licensed full-service clinically owned and operated health care company, led by professionals who are passionate about delivering Exceptional Outcomes and quality care Beyond Expectation to patients, referral partners, staff and the communities that we serve.
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A medical degree as Doctor of Medicine (MD) or Osteopathy (DO) and an active and unrestricted Texas Medical License, free of sanctions from Medicaid or Medicare is required. Reporting to the Chief Medical Officer, this position provides clinical leadership and oversight of the population health management program including utilization management, case management, preventive health/disease management, and quality management while supporting the multidisciplinary member-centric approach to care management.
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ResponsibilitiesThe Home Health Aide is responsible for providing patients with in-home personal care and designated health related services to maintain the patient's physical and emotional well-being, while following the written plan of care, Medicare/Medicaid regulations and agency policies and procedures.
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You will coordinate all external audits of Medicaid and Program Integrity-related activities such as reviews by the U.S. Department of Health and Human Services' Office of the Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), and the State Board of Accounts.
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Expanded product portfolio - as an advisor, you have access to individualized supplemental product suite, marketplace ACA plans and competitive Medicare Supplements along with dental and vision plans.
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Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. Two to three years college level courses/Associates Degree/Diploma in Respiratory Care. New Mexico Respiratory Care Practitioner License, Registered Respiratory Therapist credential from the NBRC, ACLS and/or PALS , BLS required.
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We’re hiring board-certified nurse practitioner contractors to conduct In-home Health Evaluations for Medicare Advantage, Medicaid, and certain commercial plan members. We’re hiring board-certified nurse practitioner contractors to conduct In-home Health Evaluations for Medicare Advantage, Medicaid, and certain commercial plan members.
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Knowledge of Centers for Medicare and Medicaid Services guidelines related to hospice care preferred. Familiarity with insurance providers including Medicare, Medicaid and private insurance carriers is a plus.
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Experience with Medicare Administrative Contractor (MAC), Recovery Audit Contractor (RAC), Zone Program Integrity Contractor (ZPIC), Program Safeguard Contractor (PSC), or Medicare Drug Integrity Contractor (MEDIC), and other CMS fraud detection and prevention solutions is preferred.
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Accurately documents and monitors activities from data received Operationalizes and assures compliance with Center for Medicare & Medicaid Services (CMS), Occupational safety and Health Administration (OSHA), Center for Disease Control and Prevention (CDC) and Patient Safety regulations at the service line level.
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The Registered Nurse Case Management provides skilled professional nursing care and support to the hospice patient and family, including non-related caregivers, as ordered by the physician and in compliance with regulations and standards identified by the Medicare Hospice Conditions of Participation, Florida Nurse Practice Act, and the National Hospices and Palliative Care Organization.
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Since our inception in November 2019, Better Health has gained Medicare licenses in 46 states, 16 Medicaid licenses, and preferred national provider contracts with leading payers, including Oscar Health Humana, and Cigna.
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Maintains knowledge of Medicare and State specific home health care regulations. Greenville County, SC. This position requires an LPN or RN license. Promote MSA's entire umbrella of services across the home health continuum.
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1+ years of experience with long term care services and support, Medicaid or Medicare. If you are located within 30-50 miles of NE Harris County, TX , you will have the flexibility to work remotely.
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Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers.
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