- Staffing Solutions Organization (Albany, NY)
- …Long-Term Care (MLTC) Cost Reporting** **50% Remote 50% Onsite** **Summary:** The Medicaid Program Advisor will support the New York Department of ... reflection of our clients and the people they serve. ** Medicaid Program Advisor in Albany,...managed care, or government fiscal oversight. + Experience with Medicaid cost reporting, managed care financial analysis,… more
- Staffing Solutions Organization (Albany, NY)
- …a diverse workforce, which is a reflection of our clients and the people they serve. ** Medicaid Program Advisor 1 in Albany, NY** **Division of Program ... knowledge and implementation. The BASP is seeking a passionate Medicaid Program Advisor to support...performance metrics to inform the development or modification of program operations and/or policy development such as cost… more
- Wipfli LLP (Milwaukee, WI)
- …governmental developments impacting the healthcare industry + Building a trusted advisor relationship with healthcare client executives by gaining an in-depth ... budgets and forecasts + Demonstrate a thorough understanding of Medicare and Medicaid reimbursement systems + Familiarity with coding accuracy for cost … more
- Wipfli LLP (Milwaukee, WI)
- …regulatory developments impacting the healthcare industry + Building a trusted advisor relationship with healthcare client executives by gaining an in-depth ... budgets and forecasts + Demonstrate a thorough understanding of Medicare and Medicaid reimbursement systems + Collaborate with internal and client external cost… more
- Humana (Louisville, KY)
- …deliver improved health outcomes, optimized cost performance and measurable program value across Medicaid . This executive leverages advanced analytical, data ... **Medical Economics:** + Lead medical cost analysis, premium analytics, and program effectiveness initiatives for Medicaid products. + Oversee the creation… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …requirements while ensuring high levels of healthcare quality and acceptable levels for the cost of care. 3. The Physician Advisor will conduct clinical reviews ... physician with leadership experience interested in our new Physician Advisor position. 1. The Physician Advisor serves...the segmentation of concurrent review offerings into Medicare / Medicaid / Commercial Payors, as needed * Reviews medical… more
- Elevance Health (Indianapolis, IN)
- …cost , and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care ... **Behavioral Health Medical Director - Psychiatrist - Indiana Medicaid ** **Location:** This role enables associates to work virtually full-time, with the exception… more
- CVS Health (Springfield, IL)
- …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California, Florida, Illinois, ... "Work from Home" position primarily supporting the Aetna Illinois Medicaid plan and the UM team; but part of...Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a… more
- Humana (Tallahassee, FL)
- …provider performance in value-based programs. + Identify opportunities for new clinical program initiatives by assessing cost and utilization drivers, inclusive ... and help us put health first** As Regional Clinical Advisor , you serve as a key member of the...monitoring, and continuous quality improvement within the Medicare Advantage program to support improving the health of members. The… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Physician Advisor Coordinator? At Parallon, you come first. HCA Healthcare has committed up to $300 ... medical coverage that covers many common services at no cost or for a low copay. Plans include prescription...student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program … more
- Elevance Health (Hickory, NC)
- \#HealthyBlueCareTogetherCFSP **Clinical Care Advisor - Complex Medical** **$3,500 SIGN ON BONUS** _We are partnering with North Carolina DHHS to operationalize a ... statewide Medicaid Plan designed to support Medicaid -enrolled infants,...role with the field care managers for the CFSP program with the advisors supporting the care managers with… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …households who qualify for various programs, including SNAP, Cash Assistance, Medicaid , Hawki, State Supplementary Assistance, Refugee Cash and Medical Assistance, ... HIPP Program , Long Term Care Services and Supports Programs, Child...the agency strategic goals. This position is a key advisor to executive leadership and will make day-to-day decisions… more
- Independent Health (Buffalo, NY)
- …play an integral role in the rebates and drug manufacturer contracts program . This will include assisting in the administration, analysis, pricing, and optimization ... + Proven examples of displaying the PBD values: Trusted Advisor , Innovative, Excellence, Guardianship, Dedication and Caring. **Essential Accountabilities** +… more
- Atlantic Health System (Morristown, NJ)
- …fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid compliance, licensure issues, pay-to-play issues, corporate governance and regulatory ... appearance releases, consents to videotaping, etc. -As requested, serve as legal advisor to various committees, work groups and task forces. Work collaboratively… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for all enterprise quality performance programs across the organization's Medicare, Medicaid , ACA, and Commercial lines of business. This position leads the ... to members. The Director serves as a visible leader and trusted advisor to executive leadership, driving enterprise collaboration to achieve quality excellence. Your… more
- Houston Methodist (Houston, TX)
- …plan of care and services provided are patient-focused, high-quality, efficient, and cost -effective. Serves as a preceptor and implements staff education specific to ... continued stay, and resource use, appropriate level of care and program compliance. Identifies when services no longer meet evidence-based criteria, initiates… more
- Humana (Springfield, IL)
- …and identify the greatest sources of value. The Strategy Advancement Advisor will drive strategy development by collaborating with a multi-disciplinary team ... to identify discrete opportunities for enhanced clinical outcomes, cost control, quality, and member experience. **_Responsibilities include the following:_** +… more
- Houston Methodist (The Woodlands, TX)
- …care and services provided are patient-focused, high quality, efficient, and cost -effective; facilitates timely: - completion and reporting of diagnostic testing; - ... admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Millman l criteria,… more
- Houston Methodist (The Woodlands, TX)
- …of care and services provided are patient-focused, high quality, efficient, and cost -effective. + Serves as a preceptor and implements staff education specific to ... admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Milliman l criteria,… more
- Grifols Shared Services North America, Inc (Minneapolis, MN)
- …territory including major accounts and large players (ie, Commercial, Medicare, and Medicaid ) *Understanding of Hospital formulary with guidance of RSD and NAM/NAD ... customers. *Become a valued strategic partner as well as trusted advisor offering customer-centric solutions. Consistently demonstrate follow-through for the benefit… more
