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Maintain continuous communication with the resident, responsible party, outside attorney, facility attorney or outside provider if the application was completed with someone other than the Medicaid Coordinator, in conjunction with the Business Office Manager.
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Provide direct representation, advocacy, education, and counseling to consumers and/or their caregivers or advocates, concerning eligibility for Medicaid, problems with enrollment and disenrollment in managed care plans, benefits coverage and access rules and procedures, member rights and responsibilities, and appeals.
$51,289 - $55,449 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Medicaid Eligibility Analyst who will embrace our mission of Advancing Health Together. Coordinate and facilitate the Medicaid application process across multidisciplinary entities to obtain Medicaid eligibility for patients entitled to Medicaid for the purpose of attaining reimbursement for services provided by Duke University Health System.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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We are currently seeking a full time Medicaid Coordinator who will embody the passion and commitment required to deliver the ultimate care for our residents. Review all documentation including 60 months of banking to determine Medicaid eligibility or penalty periods incurred.
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The Policy Analyst – Payment Reform position works in collaboration with the Policy Division and Payment Reform Team to support CHCs in Medicaid and other payment methodologies, including value-based care, and monitors and influences the Colorado Medicaid and behavioral health systems, payment and health system reform and other issues impacting CHCs and their patients.
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Additional recent significant cases include the indictment of a Long Island physician for defrauding Medicaid and subjecting patients to invasive and unnecessary testing, conviction of former fugitive dentist for Medicaid Fraud and prosecution and convictions of persons involved in a homicide and cover up at a nursing home in Suffolk County.
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The Eligibility Specialist is responsible for assisting hospital patients with the completion of the application process for Medicaid. Emerus distinctive level of care earned the Guardian of Excellence Award for Superior Patient Experience in six of the past seven years.
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Abides by and ensures fluency of all OPWDD (Office for People with Developmental Disabilities), Self-Direction, Medicaid and associated programmatic regulations. Abides by all OPWDD (Office for People with Developmental Disabilities), Self-Direction Guidance, Medicaid and additional regulations.
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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 role is likely to be focused on either Medicaid Managed care data used for compliance and oversight, or on the Medicare Quality Review Program. Preferred: Knowledge of Medicaid payments and claims.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The State of Nebraska, Department of Health and Human Services, within our Medicaid and Long-Term Care Division, is actively seeking a dynamic individual to serve as the Medicaid Pharmacy Director.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Initiates and monitors RAI process tracking, discharge/reentry and Medicaid tracking forms through the PointClickCare system. Communication with central resident assessment coordinator potential Hospice referrals, any potential Medicaid CMI captures, or PDPM IPA captures, or need for any significant change of status MDS assessment completion.
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Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
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Adheres to all Corporate and Departmental policies and ensures all regulatory requirements such as DOH, CMS, Medicaid, and accreditation requirements such as NCQA, URAC and HEDIS functionalities are met or exceeded.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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An Excluded Party is a person that the federal or state government found not eligible to provide care and services in a Community that receives Medicare or Medicaid funding. Regulatory Disclosures for Senior Living Communities with Medicaid Residents: An "Excluded Party" is a person that the federal or state government found not eligible to provide care and services in a facility that receives Medicare or Medicaid funding.
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medicaid job Title: care physician Company: Ima Medical Group
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