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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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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.
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Job Description :Medicare Risk Adjustment Advanced Analytic SeniorLocation: This position will work a hybrid model (remote and office). Minimum Requirements:Requires MS, MA, or PhD with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research, a minimum of 3 years direct experience programming large, multi-source datasets with SAS required, and a minimum of 3 years in health care setting; or any combination of education and experience which would provide an equivalent backgroundPreferred Skills, Capabilities, and Experiences:PhD preferred.
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Emergency Department registration experience, strongly preferredKnowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors, required. Emerus’ leading national health system partners include Allegheny Health Network, Ascension, Baptist Health System, Baylor, Scott & White Health, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS and MultiCare.
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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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Certification preferred in any of the following areas: medical insurance carriers, Medicare, Medicaid, commercial insurance, patient scheduling, or medical office specialist. As a Scheduler/Registrar, you will be responsible for scheduling and pre-registration of all outpatient exams for Centralized Scheduling and for communicating with patients, medical staff and interdepartmental personnel regarding customer needs.
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Preferred Qualifications Three (3) years of experience working with standards and compliance regulatory bodies such as Centers for Medicaid and Medicare (CMS), Illinois Department of Public Health (IDPH), Joint Commission and/or Occupational Safety and Health Administration (OSHA.
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Knowledge of Medicare reimbursement and coding for all levels of service - home, office, nursing home, assisted living, etc., Medicaid and other regulatory requirements. Use these rewards to support your wellbeing with spa/massage/salon services, gym memberships, fitness classes, sports, hobbies, pets and more.
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Considerable knowledge of federal assistance programs, including Medicaid, TANF, and HUD funded housing assistance programs. senior director | programThe Senior Director of Program is responsible for the overall health and management of the services that occur within one or more of the following: Foster Care and Residential Services, Homeless Youth Services, and Youth and Family Services.
$110,000 - $137,500 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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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Compliance with applicable Federal, state and local regulations; CARF standards, Medicaid Waiver. Will perform all duties necessary to meet state approved objectives, including the requirement that the employee cooperate with Benchmark Human Services and staff from the Department of Human Services (DHS), the Division of Developmental Disabilities (DDD), the Office of Licensing (OOL) as well as the Department of Children and Families (DCF) in any inspection or investigation.
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The Audit and Reimbursement II will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services.
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CCPA Notice for Job Applicants, Contractors, and Employees Residing in California 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.
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Person MUST come with 1 year of experience and knowledge in Veteran Affairs, Worker Compensation, Medicaid, Medicare Advantage, PPO and Prior Authorization Appeals. Volt is immediately hiring a Benefits Specialist in Orlando, FL As a Benefits Specialist , you will: Person will be doing Verification of Benefits in the Appeals process for prior authorization / denials / exceptions, etc.
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Work on issues related to Medicare coverage determinations, Medicaid coverage and preferred drug list determinations, FDA drug development and safety policies, agency guidance policies related to patient engagement and diversity equity and inclusion (DEI) impacting health access, clinical trials, and research opportunities.
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medicaid job Company: A Fox Physical Therapy P C
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