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Three (3) or more years experience in Medicare Advantage and risk adjustment data analytics, including the use of databases, required. Proven ability to communicate Medicare Advantage and related encounters or claims accuracy and reconciliation.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Coordinate with Network Informatics, Finance, and other Network Managers to develop and monitor the facility budget for new and existing regional facility systems as well as develop a competitive intel process leveraging transparency data as well as Medicare and Medicaid pricing.
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The ideal candidate will also be knowledgeable in Medicare, Medicaid, and private insurance, as well as the ability to complete relevant insurance documentations. The ideal candidate will also be knowledgeable in Medicare, Medicaid, and private insurance, as well as the ability to complete relevant insurance documentations.
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Knowledge of MDS, payer systems and contracts (Medicare, HMOs, Managed Care, Third Party Payer Systems) Presbyterian Homes & Services - Maranatha is seeking a full time Admissions Nurse for its team.
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Pivotal Health is in network with all major health insurers including UnitedHealthcare, BlueCross BlueShield, Humana, Aetna, The Alliance, and Cigna and is Medicare-certified. Pivotal Health is partnering with providers in the Minneapolis/St. Paul area to transform urgent care and primary care with its innovative clinician house call service.
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From rapid deployments to entire transformations, you'll deliver leading edge Medicare and Commercial strategy and operations capabilities to our clients. Minimum of 3 years of experience in HealthRules Payer configuration, with a strong background in Medicare Advantage plans and Claims Administration.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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We uniquely align the interests of health consumers, providers, and payors to make high-quality healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.
InternExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Including those set forth by regulatory bodies such as Center for Medicare and Medicaid Services (CMS), United Network for Organ Sharing (UNOS), Association of Organ Procurement Organizations (AOPO), Food and Drug Administration (FDA) and American Association of Tissue Banks (AATB) and Eye Bank Association of America (EBAA.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Medicare Part D knowledge (2+ years' experience for the team lead; for the other delivery team members, this is preferred) Medicare Part D knowledge (2+ years' experience for the team lead; for the other delivery team members, this is preferred.
RemoteExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Domain expertise in Medicare/MA and population health. This is a full-time, exempt position reporting to the Chief Technology Officer. Additional total compensation includes company equity, comprehensive health benefits, and flexible remote work environment.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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The Sr. Service Advocate will drive member retention in the Minnesota Medicare market by supporting service operations which could include calls, claims, correspondence, and face-to-face member appointments.
$18.5 - $37.02 an hourFull-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Marketing Advisor, DTC Advertising (Medicare Advantage) - Hybrid. Additionally, will be required to partner effectively ensuring all acquisition campaigns and materials are aligned with other channels, meet brand standards and can positively impact Cigna’s Medicare Advantage growth goals.
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Sholom has built a reputation for excellence in providing high quality elder care, with both campuses being recognized as Five Star facilities for overall quality from the Centers for Medicare & Medicaid.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Advocacy - Leading voice with Administration officials to improve federal rules and regulations affecting Medicare, Medicaid, Duals, and CHIP. Work in close partnership with lobbying team to support congressional education and engagement, including federal lobbying activities on Capitol Hill, as well as with state officials focused on Medicaid solutions.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Successful experience working with complex insurance payer claims, denials, and appeals (Medicare and commercial) Must have a strong working knowledge of Medicare and commercial insurance and be able to relay detailed medical criteria information in order to maximize the HCP and staff experience.
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