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Preferred Location: Hanover, MD.The Medicare Risk Adjustment Advanced Analytic Senior Is responsible for creating statistical models to predict, classify, quantify, and/or forecast business metrics.
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Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. Two to three years college level courses/Associates Degree/Diploma in Respiratory Care. New Mexico Respiratory Care Practitioner License, Registered Respiratory Therapist credential from the NBRC, ACLS and/or PALS , BLS required.
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The WellBe care model is a Physician Led Advanced Practice clinician 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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Sage Health builds enriching neighborhood health centers that are easy to access, provide or arrange for all of our patients’ healthcare needs, and partner with Medicare Advantage plans that fully cover primary care.
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Completes Medicare Compliance and obtains ABN if necessary. Responsible for obtaining complete and accurate demographic and financial information from a variety of sources, including patient interviews physician offices and in-house departments.
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Job Description :Audit & Reimbursement II - Medicare Cost Report AuditLocations: This is a virtual position, the ideal candidate will live within 50 miles of an Elevance Health PulsePoint location.
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Knowledge of all pertinent federal and state regulations, filing and compliance requirements, both adopted and pending, affecting employee benefits programs, including the ACA, ERISA, COBRA, FMLA, ADA, Section 125, workers' compensation, Medicare, OBRA, and Social Security and DOL requirements.
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The Sr Director, Risk Adjustment Strategy and Program Management works collaboratively with Florida Blue Medicare, Florida Blue, and GuideWell executives and leadership to lead risk adjustment strategy and process.
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In cases where Tricare or Medicare/Medicare Advantage is primary or secondary, use scripting to review and deliver appropriate regulatory form (Tricare Rights, Tricare Third Party Liability, and Important Message from Medicare (IMM) form.
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In particular, the AVP will play a critical leadership role in the development of processes relating to Medicare risk adjustment, documentation, and in-home wellness assessments (in partnership with Humana's Medicare Risk Adjustment team, as well as with external strategic partners), given the importance of these areas to the delivery of value-based care.
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You will coordinate all external audits of Medicaid and Program Integrity-related activities such as reviews by the U.S. Department of Health and Human Services' Office of the Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), and the State Board of Accounts.
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Person MUST come with 1 year of experience and knowledge in Veteran Affairs, Worker Compensation, Medicaid, Medicare Advantage, PPO and Prior Authorization Appeals. Understanding of Medicare rules and regulations Schedule: 8:30 AM - 5:00 PM This is a Full-time , Contract opportunity.
$16 - $17.8 an hourFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Preferred Qualifications Three (3) years of experience working with standards and compliance regulatory bodies such as Centers for Medicaid and Medicare (CMS), Illinois Department of Public Health (IDPH), Joint Commission and/or Occupational Safety and Health Administration (OSHA.
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Experience working with physician groups, provider contracting, market operations, and Medicare Risk Adjustment and Stars/Quality functions. The Regional VP, Operations in the Mid-Atlantic Medicare region is a Chief Financial Officer position with Operations elements as well.
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If you are interested in advancing your career as a primary care physician, please email your CV and cover letter to martin.pearson@nm.org, or visit to learn more. Full-time, Primary Care opportunities are available in several of Chicago’s exciting neighborhoods, including: Lincoln Square, Lakeview, Streeterville, Evanston and the South Loop. These locations all offer multi-cultural environments with rich history, world renowned architecture, arts and entertainment.
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medicare job Title: primary care physician Company: Ima Medical Group
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