- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects ... regulatory and CMS compliance requirements. You will manage the coding consultants who provide audit, coding expertise,...will also serve as a Subject Matter Expert for Medicare Advantage risk adjustment. Salary offers are… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive ... **Employment Type:** Full time **Shift:** **Description:** ** Manager of Coding Operations** **Why Mount Carmel?** With five hospitals… more
- CareOregon (Portland, OR)
- …healthcare, claims, data management, EDI experience Preferred + Experience with Medicare Advantage risk adjustment and payment methodologies Knowledge, Skills ... hired for remote positions must reside in Oregon or Washington. Job Title Medicare Encounter Data Analyst Exemption Status Exempt Department Finance Manager … more
- The Cigna Group (Baltimore, MD)
- …Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan ... in addition to base salary._** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment program for assigned populations in an… more
- Marshfield Clinic (Marshfield, WI)
- …and HCPCS coding . Knowledge of the different CMS guidelines that affect Medicare Advantage , HHS-ACA and DHS/BadgerCare Plus members as related to revenue ... AMA CPT coding guidelines, ICD-9 & ICD-10 Coding Guidelines, CMS Medicare , HHS, and DHS...a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she… more
- The Cigna Group (Baltimore, MD)
- …Components** All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: + ... with STARS, HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage required + Required - Microsoft Outlook, Excel, PowerPoint,… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does ... to regional offices and/or conferences and exhibits. + Staff dedicated to supporting Medicare Advantage must have working knowledge of Medicare enrollment… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... and letters of agreement. + Knowledge of provider reimbursement, Medicare reimbursement, coding and HEDIS Measures and...to develop and implement strategic initiatives. + Knowledge of Medicare Advantage and ACA risk scores and… more
- Cleveland Clinic (Cleveland, OH)
- …quality, cost, and utilization data preferred. + Knowledge of ACO, Medicaid, and Medicare Advantage quality measures, NCQA and HEDIS standards, and Medicare ... As part of the CCHS Value Based Performance team, the Program Manager will help support value based contracting, implementation, program management, and performance… more
- The Cigna Group (Bloomfield, CT)
- …in addition to base salary._** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment program for assigned populations in an ... with providers to assist in achieving accurate and complete coding documentation. The role will work under the direction...role will work under the direction of Provider Education Manager to reach overall operational market goals in conjunction… more
- The Cigna Group (Houston, TX)
- **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment & Stars program for assigned populations in an operational ... role will work directly with providers to assist in achieving accurate and complete coding documentation and addressing Stars gaps in care. The role will work under… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Prospective Payment Systems and Correct Coding Initiative + Experience in Medicare Advantage Plan, managed care or government contractor (eg: ZPIC, UPIC, ... medical terminology, ICD-9-CM, ICD-10-CM, HCPCS Level II and CPT coding along with analysis and processing of Medicare...assigned to the Operations area, as well as the Manager of FWA and VP of Administration + Meet… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... experience. Learn more at: https://prominence-health.com/ Job Summary: The Senior Claims Manager will oversee and ensure the efficiency and accuracy of healthcare… more
- Sharp HealthCare (Chula Vista, CA)
- …Rights. More fields may be added as regulations change.In cases where Tricare or Medicare / Medicare Advantage is primary or secondary, use scripting to review ... Medicare and Medi-Cal regulations. + Knowledge of ICD-10, CPT, and/or RVS coding . + Knowledge of Medicare Important Message, Medicare Secondary Payor,… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... Learn more at: https://prominence-health.com/ Job Summary: The Database Marketing Manager (Marketing) will be responsible for leveraging the technical and… more
- VIP Care (Ocoee, FL)
- …hospital portal access, state licenses, and professional memberships + Ensure compliance with Medicare Advantage Plans, HIPAA, and labor laws and is responsible ... passion and elevates your skills. Position Objective: The Office Manager is an operational and clinical role and is...read and write medical terminology + Knowledge of medical coding + Knowledge of HIPAA + Knowledge and understanding… more
- CenterWell (Phoenix, AZ)
- …+ Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by... Provider Number/ Medicaid Provider Number + Experience managing Medicare Advantage panel of patients with understanding… more
- VIP Care (Estero, FL)
- …referral requests, patient records, and medication management + Ensures compliance with Medicare Advantage Plans, HIPAA, labor laws and is responsible for ... THE OPPORTUNITY VIPcare is searching for a Clinical Office Manager (CMA, RMA, MA) to provide preventative and chronic...read and write medical terminology + Knowledge of medical coding + Knowledge of HIPAA + Basic computer skills,… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Medical Mutual' ... cross-functional Scrum team under the direction of the IT Manager . Translates user stories and customer acceptance criteria of...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Administration, Network Operations, IT, Medical Management, Benefits Administration and Medicare Advantage . Providers, provider representatives, vendors and ... + Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage staff to support internal strategies and external… more