- 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
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …help us transform healthcare? Bring your true colors to blue. What We Need The Medicare Advantage Network Performance Manager , as a member of a ... coding , and product management and marketing. To accomplish this work, the Medicare Advantage Network Performance Manager will work closely with Provider… 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
- The Cigna Group (Houston, TX)
- …All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: Growing ... experience with STARS, HEDIS, Risk Adjustment and medical expense reduction specific to Medicare Advantage required + Ability to apply an enterprise mindset with… more
- AdventHealth (Maitland, FL)
- …compliance audit concepts + Knowledge of regulations related to data submission for Medicare Advantage , MMP, and Marketplace risk adjustment. + Knowledge of CMS ... **:** + Minimum seven years of experience in RAF coding + 3 years' experience as a manager /supervisor + Bachelor's degree in business, health care, or related… 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
- CareOregon (Portland, OR)
- … and OHP risk adjustment regulations and requirements + Knowledge of medical claim coding and Medicare Advantage payment methodology Skills and Abilities + ... Job Title Risk Adjustment Analytics Manager Exemption Status Exempt Department Finance Manager...of the risk adjustment data analytics programs for the Medicare Advantage and Medicaid programs. Assists Director… more
- The Cigna Group (Chattanooga, TN)
- …Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan ... or Memphis area** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment program for assigned populations in an… 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 (Memphis, TN)
- …Memphis, TN area** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment & Stars program for assigned populations ... 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
- Sharp HealthCare (San Diego, 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
- 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 MCMG Revenue Site Operations** **Why Mount Carmel?** With five hospitals… more
- Lumeris (OH)
- …management + Demonstrated subject matter expertise in any of the following areas: Medicare advantage , Medicare Shared Savings Program (MSSP), managed care ... Thank you for your interest in Lumeris. **Position:** Population Health Manager - Hybrid - Ohio **Position Summary:** Responsible for improving Accountable… 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
- 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 (Port Richey, 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
- 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
- VIP Care (Punta Gorda, 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
- The Cigna Group (Westerville, OH)
- This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region ... role will work under the direction of the Senior Manager - National Lead Provider Education to reach overall...payer or provider operations, CMS Risk Adjustment and HCC coding process and quality including Medicare Star… more
- VIP Care (Tampa, FL)
- …medical management and performance improvement strategies to ensure success in our existing ( Medicare Advantage ) as well as net new LOBs. They will also ... + Experience in Utilization Management and Physician Improvement Programs + Experience in Medicare Advantage + Experience in Value-Based model of care +… more