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Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.
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The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local medicare patient populations at our innovative network of neighborhood primary care centers.
$215,000 - $245,000 a yearExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Preferred experience working with Medicare Fee for Service regulations including CMS Conditions for Coverage (CfC), Conditions for Participation (CfP), and other CMS Manuals; Preferred experience working with Medicare Fee for Service claims and respective electronic health record and billing IT systems.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Experience in helping patients work with Medicare/ Medicaid. We are seeking an MSW Social Worker to join our team! Experience in helping patients work with Medicare/ Medicaid. Previous experience in social work, counseling, or other related fields.
Full-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Oak Street Health is a rapidly growing, innovative company of community-based healthcare centers delivering higher quality health and wellness care that improves outcomes, manages medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities.
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You can sell just about anywhere, but the key is knowing how to spot the right opportunity.
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Under the general supervision of the Payor Contracting Director, the Senior Payor Contract Analyst is responsible for overseeing and managing commercial and Medicare Advantage payor contracts. Ensures the payor contracting department possesses relevant knowledge of commercial and Medicare Advantage payor enrollment requirements and develops and maintains provider rosters issues and a mechanism for resolving enrollment issues.
$65,190 - $97,785Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Serve as backup to notify the Medicare Billing Supervisor or Patient Financial Services Director of determination for approval. This position also is the liaison between Medicare and the Hospitals for billing issues and denials provides training, assists the Medicare billing team in processing claims to Medicare, and reviews and processes payee accounts for the Hospitals.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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We accept Medicaid, Medicare, and many commercial insurance plans and collaborate in several quality improvement initiatives. Our skilled office staff supports an integrated care team consisting of 2 physicians, 4 nurse practitioners, a PA, an RN, a PharmD, a PsyD, and a diabetes and wellness coach.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Healthcare industry experience as it relates to risk adjustment, medical claims submissions, adjudication and payment, eligibility, encounters file management in particular for Medicaid/Medicare populations.
Full-timeExpandApply NowActive JobUpdated 17 days ago - UpvoteDownvoteShare Job
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Act as the SME (Subject Matter Expert) for Provider Contracting Database, Hospital Value Metrics, Benchmarking tools as well as Profee for the entir This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region serving as a liaison between Markets and Provider Performance Enablement teams, Provider Education, and the Risk Adjustment Operations teams.
ExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
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General knowledge of benefits and compensation laws and regulations (ERISA, HIPAA, COBRA, Medicare, ACA, HSA, and Department of Labor FLSA regulations). General knowledge of benefits and compensation laws and regulations (ERISA, HIPAA, COBRA, Medicare, ACA, HSA, and Department of Labor FLSA regulations.
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Besides the typical social work, knowledge of medicaid/medicare, VA, hospice, ULTC's, Social Security, Title 19, MCD redetermination and application process, ancillary scheduling and facilitation, rep payee and more.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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This Micromarket BFO role will oversee financial strategy, planning & analysis for Medicare Advantage. The Market Business Financial Officer (BFO) will be responsible for financial strategy and analysis within a highly complex and regulated Medicare Advantage business.
Full-timeExpandApply NowActive JobUpdated 17 days ago - UpvoteDownvoteShare Job
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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.
ExpandApply NowActive JobUpdated 7 days ago
medicare job Company: Platinum Supplemental Insurance in Aurora, CO
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