- 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
- Executive Care (Leesburg, VA)
- …healthcare or related field. Experience working with healthcare/home healthcare standards and quality assurance or risk management . Working knowledge of Virginia ... HCO (Home Care Organization) and CMS (Centers for Medicare & Medicaid Services) documentation standards a plus Excellent organizational, communication, and… 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
- 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)
- …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 (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 (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** With over 10 million sales interactions annually,...understands that while great products are important, it's the quality of our service that truly defines us. We… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Call Quality Professionals provide information that will assist in the feedback and the ... your skills to make an impact** **Required Qualifications** **Active Health insurance license or the ability to obtain within...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… 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
- Public Consulting Group (Washington, DC)
- …methodologies to ensure transparency and repeatability. + Develop and implement claims-based quality metrics to assess the performance of Medicaid programs. + ... public sector solutions implementation and operations improvement firm that partners with health , education, and human services agencies to improve lives. Founded in… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Join Humana as a Utilization Management (UM) Strategy Principal, and play a pivotal role ... enterprise-wide collaboration. This role offers the opportunity to directly influence the quality and effectiveness of our utilization management programs, while… more
- CareFirst (Washington, DC)
- …Market Operations provides leadership for the operation of a single jurisdiction Medicaid program including the strategic direction for the development and expansion ... to deliver the overall strategic plan for a single jurisdiction Medicaid program. Through collaboration with matrix leaders in marketing, finance, government… more
