- Providence (CA)
- …data, and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare ... the best people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst, Medicare...providing critical insights to enhance the performance of our Medicare Advantage plans **_Providence is welcoming 100%… more
- Providence (CA)
- …of study + 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development + Experience with writing queries ... **Description** **_Providence Health Plan caregivers are not simply valued - they're...of Actuaries (FSA or ASA) + Experience certifying the Medicare Advantage Bid + Experience with Commercial,… more
- Humana (Sacramento, CA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Sharp HealthCare (La Mesa, 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 ... Hours Requirement:** **Additional Shift Information:** **Weekend Requirements:** Weekends Only **On- Call Required:** No **Hourly Pay Range (Minimum - Midpoint -… more
- Humana (Sacramento, CA)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests.… more
- 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 be responsible for assisting with the day-to-day management ... plan experience preferred + Experience processing ambulatory commercial, Medicare Fee for Service, and Medicare ...ambulatory commercial, Medicare Fee for Service, and Medicare Advantage prior authorizations desired + Knowledge… more
- Evolent Health (Sacramento, CA)
- …plan for Evolent Primary Care and sub-plans for each business segment (MSSP, Medicare Advantage , and Commercial payer partnerships) + Sets clear goals and ... development and leadership, and establishing and delivering against a clearly defined performance plan for each business segment. The SVP will assume the role of… more
- The County of Los Angeles (Los Angeles, CA)
- …and procedures that affects clinical social work, such as Centers for Medicare and Medicaid Services (CMS) regulations, Joint Commission regulations and policies, ... Medi-Cal and Medicare regulations, California Mental Health Laws, and California Board...to closure without prior notice. It is to your advantage to file your application early and not wait… more
- The County of Los Angeles (Los Angeles, CA)
- …criteria, and for certification of approved hospital days reimbursable under the Medicare and MediCal programs. Essential Job Functions + Plans, develops, and ... new staff to Federal laws and regulations pertaining to Medicare and Medi-Cal reimbursement. + Confers with physicians, administrative...to closure without prior notice. It is to your advantage to file your application early and not wait… more
- Ventura County (Ventura, CA)
- …towards medical, dental, and/or vision insurance from authorized plans. + Pension Plan : Participation in the County's defined benefit plan . APPROXIMATE SALARIES ... applications to meet business needs. It is to your advantage to apply as soon as possible. (Previously: April...provide adequate coverage of support staff functions when staff call in sick, take vacation, etc.; + Conducts regular… more
- The County of Los Angeles (Los Angeles, CA)
- …spot reviews of health facilities in the district. + Processes Medicare /Medi-Cal non-renewals and decertification and handles hearings and depositions related to ... to closure without prior notice. It is to your advantage to file your application early and not wait...Career Planning: Resources to help current and prospective employees plan a career with Los Angeles County are available.… more