- InterDent Service Corp (Oregon City, OR)
- …to increase patient referrals, market share and/or reimbursements. Review opportunities in Medicare Advantage plans, state Medicaid programs outside of Oregon ... of various dental benefit models (FFS, Indemnity, PPO, EPO, DHMO, Discount, Medicaid, Medicare Advantage ). Ideally has at least 10 years experience in the… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …enhance understanding of UM, CM, QI, and Risk Adjustment initiatives. Facilitate provider education on Medicare Advantage -specific requirements and quality ... clinical and operational programs within NEMS MSO, with a primary focus on the Medicare Advantage line of business . This role is essential in ensuring… more
- Molina Healthcare (Long Beach, CA)
- …member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, ... in a managed care setting. *Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines… more
- Sun Life Financial, Inc. (Milwaukee, WI)
- …Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage , small and large businesses, and individuals. With ... negotiation, contracting and credentialing for all products, including Medicaid, Medicare Advantage , Marketplace and Direct to Consumer, Commercial and… more
- UnitedHealth Group (Apopka, FL)
- …The CareCoach Connect program provides both longitudinal and episodic medical care to mostly Medicare -aged patients on a Medicare Advantage plan. This role ... best practices Analyze healthcare-specific data to identify trends, measure process performance , and drive decision making Design and document optimized workflows,… more
- Inland Empire Utilities Agency (Chino, CA)
- …of vital records. You'll also help shape the Agency's records policies and systems, provide expert guidance and training to staff, and play a critical part in ... To ensure that our staff can continue to perform at a high level and provide unparalleled services throughout our service area, we strive to provide a healthy… more
- Sante Health (Fresno, CA)
- …improvement, leading change management efforts, and streamlining program activities to support provider performance and patient care outcomes. This role also ... for all lines of business. Accountable Care Organization (ACO) Commercial HMO Medicare Advantage Supervise and evaluate department staff. Assure Sante meets… more
- Better-Health-Group (Tampa, FL)
- …will have a strong background in Quality and HEDIS processes related to Medicare Advantage , Traditional Medicare , Medicaid, and Commercial healthcare ... and identify trends or discrepancies. Prepare detailed reports on data quality, performance metrics, and areas for improvement. Develop and maintain dashboards and… more
- UnitedHealth Group (Houston, TX)
- …APC will provide palliative, longitudinal and episodic medical care to mostly Medicare -aged patients on a Medicare Advantage plan. The clinician will ... can be while Caring. Connecting. Growing together. APC will provide care to patients in all advertised counties :...Base Salary plus Incentive bonus target Optum Care Advanced Provider Clinician Partnership Plan 401k with match and UHG… more
- Irvine Ranch Water District (Irvine, CA)
- …MINIMUM QUALIFICATIONS Any combination of training and experience that would provide the required knowledge, skills, and abilities is qualifying. A typical ... will be invited to continue in the selection process, which will include: Performance Skills Assessment: will assess candidates' proficiency in using Excel for data… more
- Renown Health (Reno, NV)
- …in utilization review system. *Knowledge of group and individual health insurance plans, Medicare Advantage Plans, Centers for Medicare and Medicaid Services ... at the appropriate level of care to meet requirements and established financial/ performance benchmarks for Hometown Health. Incumbent will work with the Utilization… more
- UnitedHealth Group (Austin, TX)
- …Highlights: * Provide palliative, longitudinal and episodic medical care to mostly Medicare -aged patients on a Medicare Advantage plan *Conduct visits ... clinically necessary *Prepare and maintain accurate patient records, and documents * Provide palliative education to patients and families regarding chronic disease… more
- Oxford Global Resources (Albuquerque, NM)
- …of diagnosis coding Contribute to the overall development and maintenance of the Medicare Advantage internal share point site and related reference materials ... coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI...Supports monitor, and report key performance indicators (KPIs) to Senior Management Monitor trends in… more
- Trinity Health (Columbus, OH)
- …hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, ... of an ongoing modernization that will result in an all-private, 381-bed campus to provide the healthcare of tomorrow. With our new 5-story tower, Level II trauma… more
- Institute on Aging (San Francisco, CA)
- …community, fulfilling our mission. PRIMARY RESPONSIBILITY: The RN Clinical Supervisor will provide supervision to RN Case Management staff and Acute Care Management ... Work Care Management and Admin Staff. Participates in the hiring, yearly performance evaluations and termination of Acute Care Management staff. Facilitates and… more
- StateJobsNY (Utica, NY)
- …medical/health needs and services. *Visits each assigned home weekly (minimally) to provide nursing oversight and complete review of items. *Interacts with primary, ... administration. *Completes initial medication certification and conducts annual clinical performance evaluations for DSAS for procedures that include but not… more
- ShopRite (Flanders, NJ)
- …while safely dispensing medication pursuant to prescription orders and to provide attentive, knowledgeable and friendly service to all customers, while monitoring ... Must comply with all company policies and procedures. Essential Job Functions: Performance of the essential functions of this position require the Associate to… more
- UnitedHealth Group (Albuquerque, NM)
- …ability to obtain prior to employment Preferred Qualifications: Working knowledge of Medicare Advantage Risk plans Understanding of HEDIS measurements and ... Growing together. Position Highlights: In this position, the Endocrinology APC will provide patient care that is compassionate, appropriate, and effective for the… more
- Optum NM (Albuquerque, NM)
- …In this position you will provide patient care for our Medicare Advantage patients that is compassionate, appropriate, and effective for the ... the ability to effectively call on system resources to provide care that is of optimal value. What makes...Huffington Post You'll be rewarded and recognized for your performance in an environment that will challenge you and… more
- Centene Corporation (Queens, NY)
- …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special ... + Oversee Medicare -specific VBP contracts, focusing on implementation, performance management, and education of provider partners regarding CMS-aligned… more
