- Arizona Department of Administration (Phoenix, AZ)
- Medicare Operations Compliance Officer Job No: 534611 Work Type: Full-time Location: REMOTE OPTIONS, PHOENIX Categories: Administrative Support/Customer Service, ... in a competitive industry. Come join our dynamic and dedicated team. Medicare Operations Compliance Officer Division of Managed Care (DMC) Job Location: Address:… more
- Kaiser Permanente (Oakland, CA)
- Overview: The Prospective Risk Adjustment Operations team is seeking a Program Manager to lead the planning, execution, and oversight of strategic initiatives that ... support prospective Medicare risk adjustment efforts. This pivotal role will be...Employee Job Level: Individual Contributor Department: Po/Ho Corp - Medicare LOB Admin - 0308 Pay Range: $101200 -… more
- Magellan Health, Inc. (Frisco, TX)
- …positions supporting Medicare , requires 3+ years of experience working in Medicare Operations . General Job Information Title Senior Business Analyst - ... or other health insurance industries. Experience in Healthcare claims operations and/or encounter submissions preferred. Expertise in database management,...Encounter Operations Grade 26 Work Experience - Required Business Analysis… more
- SCAN (Long Beach, CA)
- … Advantage health plan environment. 5+ years of experience in health plan operations , with expertise in Medicare Advantage readiness. Leadership: Lead and ... member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 300,000 members in California, Arizona, Nevada,… more
- Molina Healthcare (Long Beach, CA)
- …and pharmacies. Assists with clerical services/tasks and other day-to-day operations as delegated. Effectively communicates plan benefit information, including but ... not limited to, formulary information, copay amounts, pharmacy location services and prior authorization outcomes. Assists member and providers with initiating oral and written coverage determinations and appeals. Records calls accurately in call tracking… more
- Mount Sinai Medical Center (Hialeah, FL)
- …regular basis with other MSMC staff as coordinated by the Director of Medicare Clinical Operations for information sharing and continuing education activities ... and participates on committees as needed/requested. *Typing of correspondence (memos and letters), statistical forms and procedures for patient reminder when overdue for screenings/tests to maintain complete patient records while keeping complete patient… more
- Great Bay Staffing Group (Gallatin, TN)
- …Director, Healthcare Leadership, End-of-Life Care, Patient Care Management, Healthcare Operations , Medicare Compliance, Clinical Operations , Healthcare ... team of healthcare professionals, overseeing all aspects of our hospice operations while ensuring exceptional patient care and regulatory compliance. This role… more
- Bristol-Myers Squibb Company (Princeton, NJ)
- …their personal lives. Read more: careers.bms.com/working-with-us. Summary: The Commercial & Medicare Channel Lead will manage forecasting and analytics for the ... Commercial and Medicare channels. This role coordinates inputs from various teams...quarterly close Maintain ongoing relationships with contracting and rebate operations teams Conduct adhoc analysis as required by management… more
- Silverado (Austin, TX)
- …our full-time team members. We are currently seeking an Area VP of Operations to provide strategic and operational leadership for Silverado Hospice within the Austin ... of hospice and palliative care principles. In-depth knowledge of Medicare and Joint Commission hospice regulations. Business acumen, including budgeting… more
- SCAN (Long Beach, CA)
- …PMP a plus. 2-4 years in workforce management, contact center support, or sales operations , ideally in a Medicare Advantage or healthcare setting. Proficiency in ... member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 300,000 members in California, Arizona, Nevada,… more
- Bankers Fidelity Life Insurance Company (Atlanta, GA)
- …claim submission, clarifying reimbursement procedures, and ensuring compliance with Medicare and industry guidelines. Educate customers about the claim adjudication ... process and policy details. Daily Operations : Maintain accurate and up-to-date records of customer interactions and transactions. Collaborate with other departments,… more
- Athari (New York, NY)
- …the Senior Director of Integrated Care Management (ICM), the Director of ICM ( Medicare ) provides clinical and administrative oversight for the Medicare Advantage ... and Integrated Benefits for Dually Eligible ("IB-Dual") populations, also known as the Medicare dual eligible special needs plan (D-SNP) line of business. This role… more
- Renew Health Consulting Services (Monrovia, CA)
- …of Revenue Management to lead and manage the billing and collections operations . This leadership role is responsible for optimizing revenue cycle processes, ensuring ... compliance with California Medi-Cal , Medicare , Managed Care , and Private Pay billing...posting. Ensure timely and accurate billing for all payers: Medicare , Medi-Cal (Fee-for-Service and Managed Care), HMO/PPO plans, and… more
- Ensemble Health Partners, Inc. (Bethel Park, PA)
- …and distributes patient education documents, such as Important Message from Medicare , Important Message from Tricare, Observation Forms, MOON form, Consent forms, ... of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and… more
- Ensemble Health Partners, Inc. (Romney, WV)
- …Explains and distributes patient education documents, such as Important Message from Medicare , Observation Forms, Consent forms, and all forms implemented for future ... of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and… more
- University of Cincinnati (Cincinnati, OH)
- …Plans As a UC employee, you won't contribute to Social Security (except Medicare ). Instead, you'll choose between state pension plans (OPERS, STRS) or an Alternative ... REQ: 99125 SF:OMJ SF:RM SF:HEJ, SF:INS SF:HERC SF:DIV SF:LJN SF:IHE Senior Financial Analyst, Dean Operations , College of Medicine Date: Jul 19, 2025 Location: more
- Regency Pacific Management, LLC (Bellevue, WA)
- …To be licensed in Oregon and Washington and any other state as VP of Operations requests Must be MDS certified through AAPACN with at least 5 years of experience ... with the RAI process Must have knowledge of Medicare /Insurance requirements related to skilled nursing care Strong knowledge of healthcare delivery systems and… more
- MBK Senior Living (Antioch, CA)
- …skills, licenses, and certifications): - Minimum six (6) months experience in dining room operations - Age over 18 years or have proper work permit and authorization ... provide care and services in a facility that receives Medicare or Medicaid funding. If employed at one of...at one of our senior living communities that receives Medicare or Medicaid funding, team members must not be… more
- Molina Healthcare (Long Beach, CA)
- …with multiple types of business data. May be internal operations -focused or external client-focused. KNOWLEDGE/SKILLS/ABILITIES Elicit requirements using interviews, ... working with complex, often highly technical teams Medicaid primary and Medicare preferable payer claims experience QNXT experience Coding experience SQL experience… more
- The University of Kansas Health System (Pavilion, NY)
- …Medical Record) appointment requests, processing external medical records, assist front desk operations as needed, and helping the physician care team prepare for ... scheduling process, including entering demographics, insurance verification, completing the Medicare Secondary Payer Questionnaire (MSPQ), scanning and document preparation,… more
