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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.
$245,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Performs actuarial functions related to Elevance MMM (Puerto Rico) Medicare Advantage businessResponsible for assisting with forecasting, budgeting, and risk adjustment modelingFrequent interaction with MMM Finance leadership team and Elevance Medicare Advantage pricing team.
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Knowledge and experience in FSS, Medicare Part D, Medicaid, and private payer policies, reimbursement process, health policy, areas of coverage and payment. Development of long-term strategic relationships with key federal customers including Veterans Administration, Department of Defense, Indian Health Services, Medicare, and State Medicaid to achieve optimal outcomes for patients treated within the Federal systems of care.
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For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30, Medicare patients associated with our community-based primary care providers. For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30, Medicare patients associated with our community-based primary care providers.
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Requires at least two (2) years experience with federal Medicare/Medicaid and Managed Care reimbursement systems with a thorough working knowledge of the MDS and RAI process; Requires a working knowledge of OBRA regulations as they relate to Skilled Nursing facilities; Requires strong working knowledge of statistics, data collection, analysis and presentation.
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Awareness of NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems. 2+ years of clinical experience, primary care, home-based medical care, geriatrics or palliative care of emergency/urgent care.
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4.1 Responsible for Medicare notices of non-coverage and help provide appropriate documentation to appeal inappropriate denials. BSW required and MSW preferred. Works collaboratively with PSM and unit leadership team to actively involve clinical nurses in the assessment and planning for patient's discharge to facility.
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Manages all aspects of Medicare reporting information to insure optimum payment according to the Omnibus Reconciliation Act 1987 (OBRA) and Perspective Payment System (PPS) regulations and federal guidelines.
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As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
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Knowledge of Workers' Compensation, Medicare and/or clinical standards of practice preferred. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions.
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Knowledge of terminally ill patients and their families along with understanding of hospice concept; knowledge of roles of all disciplines providing hospice services; excellent patient assessment skills; good oral and written communication; thorough knowledge of managed care principles, regulatory guidelines (i.e., Medicare, Medicaid, and human resource) management principles.
$122,265 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Demonstrated experience with healthcare data, particularly Medicare or other insurance claims data, clinical registry, Electronic Health Records (EHR), or patient reported outcomes for statistical analysis highly preferred.
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Provide personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Value-based care model and competitive bonuses are structured to reward outcomes.
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For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers. For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers.
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The Licensed Practical Nurse (LPN/LVN) is responsible for providing and documenting skilled nursing care, under the supervision of a Registered Nurse, in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.
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medicare job in Hamden, CT
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