Average salary: $85,659 /yearly
More stats**Become a part of our caring community and help us put health first**
The Original Medicare ('OM') Growth Strategy Advancement Lead will design and implement the new patient growth strategy for the new Original Medicare line-of-business, with a focus on grassroots patient...
Suggested
Holiday work
Full time
Temporary work
Flexible hours
...Hourly Rate ($): 30.00
Max Hourly Rate ($): 35.00
Must Have Skills/Attributes: Auditor, Health Insurance, Healthcare, Medicaid, Medicare
Job Description
**Only those lawfully authorized to work in the designated country associated with the position will be...
Suggested
Hourly pay
Full time
Temporary work
Flexible hours
Shift work
...reconciliation of the MDW, CMS 64 and eMedNY utilizing MARS reports – this facilitates claim reporting to the Centers for Medicaid/Medicare systems – T-MSIS.
Assist in querying Data sources to determine the validity of project outputs.
Document data architecture....
Suggested
Permanent employment
Local area
...of CPT, ICD-9 and HCPC codes
~ Knowledge of clinical standards of care
~ Awareness NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems
About OptumCare:
At OptumCare, we’ve found that putting clinicians at the center of care...
Suggested
Work experience placement
Local area
Relocation bonus
...to maintain compliance with regulatory standards such as the Joint Commission, NYS Department of Health, Center for Medicaid and Medicare Services, and the American Heart Association.
Salary: $54,846.00 - $87,754.00
The Stroke Coordinator provides expertise to interdepartmental...
Suggested
Permanent employment
Shift work
...and demonstrate organizational and time management skills.
Strong analytic, data management and PC skills.
Working knowledge of Medicare regulatory requirements, Managed Care Plans
A. Mission, Core Values and Service Excellence
Contributes to the creation of a...
Suggested
Hourly pay
Permanent employment
Shift work
...reconciliation of the MDW, CMS 64 and eMedNY utilizing MARS reports -- this facilitates claim reporting to the Centers for Medicaid/Medicare systems -- T-MSIS.
Assist in querying Data sources to determine the validity of project outputs.
Document data architecture....
Suggested
Permanent employment
Full time
Part time
Remote job
Work from home
...branch management and staff as well as other functional areas within the company to drive sales growth.
+ Communicate and clarify Medicare guidelines around private insurance procedures, pricing information, and product information to referral sources.
+ Maintains...
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Local area
...The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leadingclinical performance improvement projects and managing multiple complex deliverables through to implementation. Pr Clinical, Strategist...
Suggested
...Certified, and DEA registration
Possess or obtain a National Provider Identifier (NPI) issued by the US Center for Medicaid and Medicare services
Excellent verbal, writing, and interpersonal skills
Professional demeanor and integrity
Minimum Qualifications:
Graduate...
Suggested
Permanent employment
Shift work
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the...
Suggested
Weekly pay
Holiday work
Full time
Contract work
Temporary work
For contractors
Apprenticeship
Interim role
Local area
Work from home
Relocation
Home office
3 days per week
...targets.
QUALIFICATIONS:
+ A minimum of 7 years hospital and other facility successful negotiation experience for commercial, Medicare and Medicaid lines of business
+ Bachelor's Degree or 4 years of equivalent experience required
+ A minimum of 5 years...
Suggested
Contract work
Work experience placement
Flexible hours
...implementation of programs and/or project activities for the Division.
* Interacts with Project Directors from the Centers for Medicare and Medicaid (CMS) and other external sources to ensure compliance with federal standards and regulations.
* Participates in public...
Suggested
Local area
Monday to Friday
...Qualifications:
Preferred candidates will have experience in public health insurance programs, including New York's Medicaid and/or Medicare. Preferred candidates will also have excellent oral and written communication skills; strong analytical skills and attention to...
Suggested
Local area
...Certified, and DEA registration
+ Possess or obtain a National Provider Identifier (NPI) issued by the US Center for Medicaid and Medicare services
+ Excellent verbal, writing, and interpersonal skills
+ Professional demeanor and integrity
Thank you for your...
Suggested
Shift work
...State, Federal or Local government agencies.
~60 months experience in a Medicaid environment and the interactions between Medicaid, Medicare, providers and other state and federal agencies and programs.
~60 months experience with developing and maintaining working...
Local area
...is preferred
High School diploma or equivalent preferred
Patient Support Service experience, preferred
Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred
Knowledge of DME, MAC practices if...
Hourly pay
Full time
Temporary work
Work experience placement
Local area
Remote job
Flexible hours
Shift work
Monday to Friday
...communicated payer decisions in a timely manner. Manages Medical Necessity as service necessitates and identifies patients needing Medicare Advance Beneficiary Notices (ABNs)
* Assist with the maintenance of Authorization Requirements by Payer database to ensure...
Contract work
Shift work
...Possibility of extension).
Required Experience:
~60 months experience in a Medicaid environment and the interactions between Medicaid, Medicare, providers and other state and federal agencies and programs.
~60 months experience with developing and maintaining working...
Hourly pay
Contract work
Local area
...Comfortable working and communicating NCCN guidance including covering category 2B off-label recommendations for determination of Medicare reimbursement eligibility
~ In-depth knowledge of coverage and access for pharmacy-benefit & medical-benefit products, including...
Local area
Remote job
Flexible hours
...multiple tasks and priorities.
Duties Description The Medicaid Drug Rebate Program (MDRP) is a program that includes Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, and participating drug manufacturers that helps to offset the Federal and...
Holiday work
Permanent employment
Full time
Contract work
For contractors
Remote job
Shift work
...are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents
Competency, Skills and Abilities:
Excellent customer...
Full time
Flexible hours
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the...
Weekly pay
Holiday work
Full time
Temporary work
Apprenticeship
Remote job
Work from home
Home office
...and master data management solutions in support of larger data enterprise including linking provider populations in Medicaid and Medicare programs
* Analyzing information in support of linking across data sources, performing analytics across data sources such as Provider...
For contractors
...and tracking project schedule and budget performance.
~60 Months working on IT projects in the Healthcare industry, Medicaid, or Medicare Systems.
~ Bachelor’s degree in information technology or computer science or similar field of study.
~24 months holding (PMP)...
Local area
...billing, quality and Value Based Care measures and metrics. Risk Adjustment knowledge/experience is preferred.
Understanding of Medicare, ACD, Medicaid, and health plan benefit structures.
Strong management experience or demonstrated ability to lead, prioritize,...
Holiday work
Permanent employment
Temporary work
Remote job
Flexible hours
Shift work
Weekend work
Monday to Friday
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the...
Holiday work
Full time
Temporary work
...benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome.
Collaborate with our internal nurse resources (Medical Case...
Holiday work
Permanent employment
Contract work
Traineeship
Local area
...candidates will have professional experience in public health insurance programs, including New York's Medicaid, Child Health Plus, and/or Medicare. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to...
Holiday work
Permanent employment
Local area
Shift work
...accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines.
+ Support the reporting of healthcare data elements (e.g. diagnoses and...
Remote job
Shift work