- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Annapolis, MD)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- AmeriHealth Caritas (Washington, DC)
- …dual eligibility health insurance, ACA Exchange Business & DSNPs. + 5 years provider contracting/ reimbursement experience in healthcare setting. + 3 years of ... Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. This position is also responsible… more
- Humana (Annapolis, MD)
- …2 who initiates, negotiates, and executes physician, hospital , and other provider contracts and agreements related to Medicaid health plans. The ... and independent determination of the appropriate courses of action. The Provider Contracting Professional 2 responsibilities include (but not limited to): +… more
- Humana (Annapolis, MD)
- …executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and ... responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to… more
- Genesis Healthcare (Bowie, MD)
- …standards of care. *Manage the overall process and tracking of all Medicare/ Medicaid case-mix documents to assure appropriate reimbursement for services provided ... through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative,… more
- Gentiva (Beltsville, MD)
- …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… more
- GetWellNetwork, Inc. (Bethesda, MD)
- …outcomes. + Additional knowledge around payer-side healthcare operations, particularly in Medicaid /Medicare, with expertise in provider enrollment and services ... to stay up to date on market trends, and provide recommendations on new tools and technologies to improve...solutions with an understanding of costs and provider needs. + Evaluate and translate business requirements into… more
- Somatus (Rockville, MD)
- …country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious ... of 3 weeks' Vacation (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting teammates physical and mental well-being… more
- Trinity Health (Silver Spring, MD)
- …Regulatory and Accreditation Coordinator is responsible for ensuring the hospital remains compliant with all regulatory standards, accreditation requirements, and ... state and federal laws. This individual collaborates with hospital leadership and staff to maintain survey readiness and...as The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), and state health departments in collaboration… more
- US Anesthesia Partners (Rockville, MD)
- …facility has earned a five-star rating from the Centers for Medicare & Medicaid Services! Contact Callie Wade, Sr. Clincial Recruiter for more information! Email ... sharing with immediate 401k matching contributions + Continued education and professional reimbursement fund + Liberal time off program with company paid holidays +… more
- Humana (Annapolis, MD)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy… more
- Novo Nordisk (Washington, DC)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... strategies + May develop and utilize relationships with specialists, key hospital decision-makers, and other individuals who make or influence the purchasing,… more