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We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
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Channel Marketing Director, Medicare Advantage - Hybrid. The Marketing Director will be responsible for leading the channel marketing team that supports the Cigna Medicare Advantage (MA) business.
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Contractual arrangements include but are not limited to Medicaid, Commercial, Medicare Advantage, Medicare Accountable Care Organization (ACO) Reach, ACO – Medicaid, Capitation and global shared savings/risk.
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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.
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Elim Wellspring is a Medicare/Medicaid-certified facility offering 24-hour skilled nursing care, on-site rehabilitation, and restorative nursing programs. Join Elim Wellspring as a Certified Nursing Assistant (CNA) and take advantage of our comprehensive training program that includes CNA certification.
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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.
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Summary The Risk Adjustment Reporting & Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Cigna's Medicare Advantage Risk Adjustment business. Summary The Risk Adjustment Reporting & Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Cigna's Medicare Advantage Risk Adjustment business.
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Description : JOB SUMMARYThis 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.
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The WellBe care model is a Physician Led, Advanced Practice Provider driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients.
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Our 1,000+ clinicians serve more than 1,500 senior living community partners across 33 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans.
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Current and valid state licensure as a Licensed Clinical Social Worker (LCSW), Psychologist, or Licensed Mental Health Counselor (LMHC). We are seeking a dedicated and experienced Licensed Clinical Social Worker (LCSW), Psychologist, or Licensed Mental Health Counselor (LMHC) to join our team at Curana Health.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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Perform complex Medicare cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit. Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement.
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Commercial and Medicare Advantage patient management (Value-Based Care) Active/Unrestricted Medicare and Medicaid numbers. Knowledge of Medicare coverage and guidelines. Our practices offer Chronic Disease Treatment/Management, Women’s Health, Wellness, X-Ray/Ultrasound, Dental, Chiropractic, Urgent Care, Managed Care, and Workers Comp Services.
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General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts.
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