- Humana (Washington, DC)
- …Based Services, Medicaid and Medicare integration, D-SNPs, and Self-Directed Services. The Capture Lead , Medicaid Clinical & Population Health ... put health first** Humana Healthy Horizons is seeking a Capture Lead , Clinical & Population...clients and populations served in target growth markets. The Lead , Medicaid Clinical & Population… more
- Humana (Washington, DC)
- …(MA) and Special Needs Plan (SNP) populations that benefit from payer led clinical services. This role will focus on opportunities to improve member health outcomes, ... member and provider experience, clinical quality, and savings to medical costs. The Strategy...quality, cost, and experience for members and providers + Lead cross-functional teams to define discrete opportunities that are… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Clinical Strategy team is a multi-disciplinary team focused on creating data-driven strategies to ... reducing unnecessary costs from the healthcare system. The Utilization Management Strategy Lead role works closely with internal and external stakeholders, such as … more
- Trinity Health (Silver Spring, MD)
- …using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **Responsibilities:** + Monitors accuracy of centralized coders' charge ... capture and coding with proper ICD-10, CPTs, as well...of ICD-10, CPT, and HCPCs modifiers. Knowledge of Medicare, Medicaid , and other third-party billing rules and regulations. +… more
- Somatus (Mclean, VA)
- …while working within a specified budget. + Payment Integrity Product Areas- Clinical Claim Review, Payment Analytics, Fraud Capture and Utilization Review ... opportunities + And more! The Senior Vice President of Finance will lead financial activities that support critical operational stakeholders. The key areas of… more