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Knowledge of Medicare Risk Adjustment and Medicaid. Knowledge of Medicare Risk Adjustment and Medicaid. The Vice President ensures the program complies with all Centers for Medicare and Medicaid Services (CMS) guidelines, NYS laws (Article 28, 36, and 44), and all other licensure requirements and standards of performance.
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A Medicare Sales Representative focuses on helping people who are eligible for Medicare find a plan that meets their needs and aids them with the enrollment process. What Does a Medicare Sales Representative Do.
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The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other relevant study-related documents to create a coverage analysis/billing guide.
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The Center for Medicare and Medicaid (CMS) is launching a new value-based care program to disrupt Traditional Medicare, and we believe that this represents an opportunity to achieve the meaningful change we envision.
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The team advises business clients on industry specific issues in the US and Canada including: the Federal Anti-kickback Statute (AKS), the False Claims Act (FCA), HIPAA, Privacy, Marketing and Promotional issues, FDA and Regulatory issues, Compliance issues, Clinical issues, Reimbursement issues, Medicare billing and provider issues, and other federal, state, and Canadian laws applicable to a medical device manufacturer or durable medical equipment supplier.
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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.
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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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Analytics experience with Medicare Advantage, Medicare FFS, MSSP and ACO programs, and commercial populations. Proficiency with data visualization tools such as PowerBI, Tableau, or Sigma Familiarity with Snowflake or other cloud-based query applications Actuarial/statistical based analysis Experience with extraction, transformation, and loading disparate healthcare data sources Demonstrated ability to work on multiple projects simultaneously while leading a team Understand current issues in health care financing, delivery, policy, and regulations.
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Instruct patient and family members on proper use of equipment such as wheelchairs, braces, walkers, crutches, canes, and other prosthetic/orthotic devices Policies: Completes all clinical documentation following agency protocol and Medicare/Federal guidelines.
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The AVP will play a key leadership role on the HQRI team, partnering directly with the HQRI leadership team, leaders across the enterprise, including Market leadership, and external companies to create Medicare Risk Adjustment strategies to support Humana's industry leading position.
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The Director, Group Medicare Sales and Labor Relations sells health insurance and related products to new large group accounts (generally 300+ contracts) and leads the Labor Relations team. The Director, Group Medicare Sales and Labor Relations requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
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Inova’s hospitals are consistently recognized by the Centers for Medicare and Medicaid Services (CMS), U.S. News & World Report Best Hospitals and Leapfrog Hospital Safety Grades for excellence in healthcare.
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Medicare Wellness RN in the office 3 days/week as well as a full time Triage RN. Take in music, theatre and dance performances at the Palladium, the Tarkington and the Studio Theater at The Center for the Performing Arts. Shop the upscale Clay Terrace Lifestyle Mall and the trendy Carmel Arts & Design District.
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Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
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Monitor and audit charts weekly for: Episodic; Medicare documentation; all assessments; nursing summaries, MARs; treatment; flow sheets; residents profile for CNAs. Ensures that annual competency evaluations and performance reviews are completed in the appropriate time frame.
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medicare job Company: Capital Markets Placement
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