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Experience with Medicaid or Medicare Advantage value-based care contracts and financial modelingFinancial models experience such as pro-forma modeling or financial forecastingExperience with Medicaid or Medicare Advantage risk adjustmentMinimum Requirements:Requires a BS/BA degree in related field and a minimum of 5 years experience; or any combination of education and experience which would provide an equivalent background.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Provide subject-matter knowledge on Medicare, Medicaid and private commercial coverage, coding and payment policy and other market access-related issues impacting healthcare sectors including diagnostic laboratories, medical devices, pharmaceuticals and biologicals.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Accessibility - We believe quality mental healthcare should be accessible to everyone so we accept almost all insurance and EAP benefits, including Medicare and Medicaid, offer reasonable cash rates for the uninsured, telehealth for those who can’t come into the office, and appointments outside of standard office hours.
$60,000 - $95,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. We offer care management programs for asthma, diabetes, and high-risk pregnancy.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Demonstrates expertise of all payors, including Medicare, Medicaid and commercial payors, and applicable department’s revenue cycle operations. High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Minimum of one year experience involving care management responsibility in an acute care hospital Must possess a thorough working knowledge of Medicare, Medicaid and managed care utilization review requirements.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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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.
$19 an hourFull-timeRemoteExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The Assistant General Counsel I supports and reports to the Chief Legal Officer and provides legal advice on a wide variety of matters related to Community's Medicare, Medicaid and Marketplace programs and operations including contracting, quality, utilization management, network management, privacy and security, litigation, fraud, waste and abuse, and contractual and regulatory compliance.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Experience with Medicare Part D, Medicaid, and/or third-party insurance billing. A unique characteristic of HOPE Clinic is its capacity to provide services in 30 different languages, including: Mandarin, Cantonese, Vietnamese, Korean, Burmese, Arabic, and Spanish.
Part-timeExpandApply NowActive JobUpdated 26 days ago - UpvoteDownvoteShare Job
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Active and unrestricted DEA license Medicare Provider Number Medicaid Provider Number Minimum of two to five years directly applicable experience preferred Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment preferred.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Utilize TDH online Medicaid eligibility systems to verify correct recipient numbers and Medicare DDE online system to verify information prior to billing, enter a correction or void claims.
ExpandApply NowActive JobUpdated 6 days ago
medicare medicaid jobs in Houston, TX
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