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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 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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All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
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In partnership with Highmark Medicare Advantage Plan, the 65+ practice will focus on optimization of chronic health conditions, maintenance of mobility and functional status, nutrition, and medication needs to improve healthy aging.
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Understanding of Medicare, Managed Care and Medicaid reimbursements. The Registered Nurse Assessment Coordinator (RNAC) is accountable for coordinating and overseeing the full collaborative, interdisciplinary assessment and care planning process in skilled nursing.
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Proficiency in working with payer on-line portals ex: Medicare, Medicaid, NaviNet preferred along with working knowledge of Commercial Insurances and Mental Health benefits. Minimum of one year of experience working in a hospital or physician office verifying medical insurance coverage and a working knowledge of insurance plans and products, benefits and authorization processes.
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Communicates and advises appropriate internal and external stakeholders on Medicare Compliance and Medicare Set-Aside (MSA) matters including, but not limited to, lien negotiation efforts, MSA submissions and/or general information.
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The AVP will play a key leadership role on the HQRI team, partnering directly with the HQRI leadership team, leaders across the enterprise, including Market leadership, and external companies to create Medicare Risk Adjustment strategies to support Humana's industry leading position.
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Deep Medicaid experience is critical, as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined modular certification (SMC) and outcomes-based certification (OBC.
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Unique role benefits: The total compensation range for this position is $55,000 - $100,000 per year (Base Pay + Uncapped Monthly Medicare Discretionary Incentive Plan) Eligible for Allstate’s full employee benefits from day one, including health insurance, pension, 401(k), tuition reimbursement, well-being programs and so much more We prioritize creating a culture that values your work/life balance.
$55,000 - $100,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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/or Affordable Care Act (ACA) using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines.
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We recently received a 4.9/5 star rating in patient experience and a score of 98% in MIPS by Medicare. These specialty services include areas such as orthopedic rehabilitation, aquatic therapy, balance and vestibular therapy, lymphedema treatment, pelvic floor therapy, and womens health.
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Meet federal and state eligibility requirements to participate in VA, Medicaid, and Medicare Responsibilities: Coordinate psychiatric care in the facility and provide clinical guidance and oversight regarding the implementation of resident care policies.
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Follows all Medicare, Medicaid, and HIPAA regulations and requirements. Follows all Medicare, Medicaid, and HIPAA regulations and requirements. Position Summary: This position will be responsible for treating patients by teaching them different exercises intended to strengthen or stretch muscles as well as alleviate pain.
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Monitor documentation audits, Medicare compliance and patients approaching MMR cap. Monitor documentation audits, Medicare compliance and patients approaching MMR cap. The Physical Therapist Clinical Director is responsible for complete oversight of operations and administration of rehabilitative outpatient clinic providing Physical and Occupational Therapy.
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medicare job in Dover, DE
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