- Home Care Evolution (Vienna, VA)
- …you a Licensed Practical Nurse (LPN) with a passion for patient care, coordination, and quality assurance in home health ? Join our growing team at Virginia Home ... 24 hours Benefits: 401(k) Competitive salary Dental insurance Flexible schedule Health insurance Opportunity for advancement Training & development Now Hiring:… more
- Elevance Health (Washington, DC)
- …coordination, communication, and implementation of a strategic clinical quality management and improvement program within assigned health plan. Responsible ... for working with the regional head of quality management to direct the clinical ...quality measures per state, Centers for Medicare and Medicaid Services (CMS), and accrediting requirements **Required Qualifications:** +… more
- CVS Health (Annapolis, MD)
- …complex contracting options, financial/contracting arrangements and regulatory requirements. + Medicaid Network Management experience, preferably Maryland ... At CVS Health , we're building a world of health...and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. **Responsibilities** **include:**… more
- Humana (Washington, DC)
- …Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other ... a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines… more
- Humana (Washington, DC)
- …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 ... part of our caring community and help us put health first** The Associate Vice President (AVP) of Medicare...first** The Associate Vice President (AVP) of Medicare and Medicaid Encounter Submissions is responsible for the integrity, accuracy,… more
- Humana (Washington, DC)
- …Professional initiates, negotiates, and executes physician, hospital, and/or other Behavioral Health contracts and agreements within the Virginia Medicaid space. ... and reimbursement rates to providers in building and maintaining Medicaid Behavioral Health provider networks. Analyzes the...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth ... skills for technical and non-technical audiences + Demonstrated project management skills with the ability to drive work independently...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Prime Therapeutics (Washington, DC)
- … plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a health plan, healthcare consulting firm, PBM, or other government ... we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government Programs - Medicare &… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and… more
- CVS Health (Annapolis, MD)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...each and every day. **Position Summary** Responsible for performing quality inter-rater review audits of medical records coded by… more
- CVS Health (Annapolis, MD)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment… more
- CVS Health (Washington, DC)
- …from the National Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance, Medicaid Investigations, MCO Medicaid FWA Unit in the ... At CVS Health , we're building a world of health...comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the… more
- Cardinal Health (Washington, DC)
- …medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare, Medicaid ). + Proven leadership and team management abilities. ... **Job Summary:** The Manager, Revenue Cycle Management , is responsible for overseeing the insurance collection...operations of the insurance follow-up team, ensuring productivity and quality standards are met. + Monitor aging reports and… more
- HCA Healthcare (Falls Church, VA)
- …will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with ... verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management , customer service, payroll and… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Quality Assurance Professional 2 develops and implements programs to establish and ... and improve same. Trains and/or coaches staff and management in areas such as quality improvement,...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... an acute care setting + Previous experience in utilization management /utilization review for a health plan or...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …Resources Department including hiring and disciplinary actions. Continually audits/reviews service quality , staff service competency, and management of grants, ... Behavioral Health Manager - Youth & Family Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/5116809)...Youth & Family Division. Responsible for the provision and management of all Outpatient Child, Youth, and Family Mental… more
- Humana (Washington, DC)
- … first** Become a part of our caring community and help us put health first The Encounter Data Management Professional will conduct research and analysis ... 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… more
- Humana (Washington, DC)
- …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 ... part of our caring community and help us put health first** The Print Project Manager is responsible for...The Print Project Manager is responsible for the end-to-end management , production, and distribution of printed materials. This role… more
- CenterWell (Washington, DC)
- …our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... **Proposed Requirements:** + Bachelor's degree in a relevant field (eg, Health Information Management , Business Administration, Healthcare Administration) +… more
