- UpvoteDownvoteShare Job
- Suggest Revision
The Program Manager is a key member of the Medicare Advantage Claims, Configuration and Appeals and Grievance Operations team. Assists in planning, developing, implementing, and managing the Medicare Advantage Claims, Appeals and Grievance program requirements, operational initiatives and policies.
RemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
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.
$33.66 - $42.92 an hourFull-timeExpandUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage. Review provider documentation of diagnostic data from medical record to verify that all Medicare Advantage and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company.
$25 - $35 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Along with the Assistant Director, Medicare Advantage Operations, the Program Manager is responsible for program management activities impacting the functional areas within the span of control of the Assistant Director including but not limited to initiation, planning, development, and monitoring of program implementations and day to day operations performance monitoring in order to ensure timeliness and compliance.
RemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
With five hospitals , over 60 free-standing outpatient clinics , a college of nursing , a Medicare Advantage plan , and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in central Ohio each year, and we've been a pillar of this community for more than 130 years.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
This job will deliver value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Health care regulatory knowledge focusing on Fraud, Waste, and Abuse; knowledge of Value-based care, Medicare Advantage Organizations, ACO REACH and MSSP programs is required. Juris Doctor and a member in good standing of a state bar association (or Registered In House Counsel with the CA Bar.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”The Capital BlueCross Government Programs Risk Adjustment coding position is a unique position that combines knowledge and experience in risk adjustment coding, Medicare and Government regulations, Medicare Advantage risk adjustment model, HHS ACA risk adjustment models, and RADV and HRADV experience.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Lead attorney for value-based care and fee-for-service contracts with government and private payors including Medicare Advantage plans. Extensive experience with private payor contracting for Medicare Advantage plans.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
As one of the nations largest not-for-profit Medicare Advantage plans, serving more than 200,000 members in California, SCAN Health Plan has been a mission-driven organization dedicated to keeping seniors healthy and independent for over 40 years.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
You will also serve as a Subject Matter Expert for Medicare Advantage risk adjustment. Knowledge of the Medicare Advantage STARS program and NCQA technical specifications. As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects while managing key performance indicators to drive operational excellence.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Experience working in Pharmacy or Healthcare preferred, knowledge of Medicare Advantage a plus. The Associate VP, Pharmacy Engineering oversees all aspects of dispensing automation and systems maintenance for CenterWell and Enclara Pharmacia's pharmacies.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits.
ExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Identify, understand and communicate plan details to patients with HMO, PPO, EPO, Medicare Advantage and. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Requirements:Coding certification required through AHIMA or AAPC (at least one of the below):Certified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC)Certified Coding Specialist for Providers (CCS-P)Registered Health Information Management Technician (RHIT)5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan experience preferred.
Full-timeExpandApply NowActive JobUpdated Today
medicare advantage jobs Company: Capital Markets Placement
FEATURED BLOG POSTS
How to Gracefully Quit a Job You Just Started
You’ve just started learning the ropes at your new job, and you've gotten to know your colleagues. But you’re already thinking about quitting. Maybe you were deciding between to job offers and realized that you’ve made the wrong choice. Or, a change in your personal circumstances means that you have to quit.
How to Professionally Reschedule a Job Interview Without Destroying Your Chances
You’ve practiced answering common interview questions and refined your “greatest weakness.’ Nothing can stop you until BAM! The flu hits your household. Or you ran over a nail and popped a tire en route to the interview. When you need to pivot, there’s a good, better, and best way to reschedule a job interview. Here’s how to do it professionally, so you can nail the gig when the timing is right.
What is a W-9 and How to Fill One Out
When you began working for yourself, you probably didn’t account for the tax reporting work that will fall on your shoulders each year. If you’re a freelancer, independent contractor, or business owner, filing your taxes is not as simple as uploading your W-2 form into some online tax preparation software. Most self-employed people need to complete a W-9 as a step for accurately reporting their earnings to the IRS. Below, you can learn how to fill out a W-9 and when to submit it.
Tightening the HR budget in 2023
With the state of the economy still uncertain, 2023 is expected to be approached with much anticipation. Human Resource leaders have many concerns, including how they will manage to accomplish their goals with budget belts already getting snug. Let’s look at some of the factors that the new year is projected to bring for HR and how to prioritize budgets to reach human capital objectives.
A Comprehensive Guide to Becoming a Better Conversationalist
Have you ever stood awkwardly next to someone at a party because you didn’t know what to say to them? How about at a networking event or on a first date? You're not alone if you’ve ever experienced this uncomfortable silence. Many people struggle to master the art of being a great conversationalist.
Why is Non-Verbal Communication Really Important?
In a world where words and phrases rule daily communication, you may wonder why non-verbal communication is important. Whether you realize it or not, you communicate more with nonverbal actions than you do with verbal communication. When you interact with your peers, people are reading your body language, facial expressions, voice, and many other factors that help fill in blanks that words can't fill.
Making Hybrid Work More Efficient
Covid was a catalyst for change in the work environment. Keeping people safe and helathy was the initial goal for employers, but the unintended result was the considerable demand in remote work. Now, onsite work has been dramatically altered to remote work, which is now transforming into a combination of the two: hybrid work.