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Provider Performance Director, Medicare Advantage (HEALTHCARE) Familiarity with Medicare Advantage and its business model. As a Government Programs Provider Performance Director, you'll develop provider engagement strategies to drive performance improvements in critical objectives such as population health management, Medicare Stars, and Risk Adjustment.
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Experience in health care, health plans, Covered California, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
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The Medicare Sales Representative is involved with health education through the distribution of health ed. In addition, the Medicare Sales Representative provides Facilitated Enrollment, helps facilitate the continuance of health insurance, and offers assistance with recertification.
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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.
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Curana Health serves more than 1,100 senior living community partners across 30 states and participates in both the MSSP ACO, ACO Reach and Medicare Advantage programs with CMS. Backed by more than $300M in venture capital funding, the organization is poised to disrupt care delivery in senior living on a meaningful scale through innovative care models and applied analytics.
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This role reports to this job: Director, Medicare Advantage Compliance & Medicare Compliance Officer. This position manages administrative elements of the Companies’ (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program, including development and maintenance of program and governance documents such as the Compliance Plan, Risk Assessment, Corrective Action Plans, Committee Charters, Compliance policies and procedures; compliance education and training activities; audit and monitoring work plans; process development improvement; regulatory research, and special projects.
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Coordinates, identifies, and/or initiates significant change MDS’ Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintain PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator Remains current with the American Association of Nursing Assessment Coordinators (AANAC) requirements.
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The Senior Financial Analyst will serve as the Solid Organ Transplant primary internal consultant responsible for providing critical analytical support for regulatory and financial implications of the Transplant components of the Medicare Cost Report (MCR.
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The Segment Marketing Senior Manager will oversee direct-to-consumer (DTC) marketing for the Cigna Medicare Part D (PDP) business, reporting to the VP of Marketing. DTC Marketing Senior Manager - Medicare - Hybrid page is loaded.
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Evaluate current contracts related to reimbursement including Therapy, all Medicaid long-term care, Medicare Advantage and other insurance to ensure terms are beneficial and current services provided align with contract terms and provide appropriate reimbursement to St. Camillus.
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Submits detailed appeal letter to payers summarizing the patient’s medical care based on review of the patient’s medical records in accordance with Medicare, Medicaid, and third-party guidelines, policies, and procedures.
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Great Place to Work®Most Loved Workplace® Forbes Best-in-State EmployerMedicare Specialist (Remote)PRIMARY PURPOSE: To coordinate, analyze and facilitate Medicare Compliance and Medicare Set-Aside (MSA) functions within the assigned team.
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Communicates and advises appropriate internal and external stakeholders on Medicare Compliance and Medicare Set-Aside (MSA) matters including, but not limited to, lien negotiation efforts, MSA submissions and/or general information.
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Provider Performance Director, Medicare Advantage (HEALTHCARE)Telecommute or Tele-Flex Options (Depending on location) - Must reside in ID, OR, UT or WAWHO WE NEEDThe Government Programs Provider Performance Director develops provider engagement strategies to drive performance improvements critical objectives such as population health management, Medicare Stars, and Risk Adjustment.
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The current full salary range for the Provider Performance Director, Medicare Advantage is $124k Low Range / $156k MRP / $203k High Range,. Serves as a Subject Matter Expert on MA programs and objectives such as quality, risk adjustment, and other Medicare programs and stays informed and updated on measures, program changes and quality gap closure processes.
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Title: medicare advantage Company: Blue Kc
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