- Novo Nordisk Inc. (King Of Prussia, PA)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription ... the DCS I maintain relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and other paramedical customers… more
- Lundbeck (Gary, IN)
- …Psychiatrist, Neurologist, Community and Institutional Accounts such as Skilled Nursing Facilities.You will drive demand creation by providing comprehensive clinical ... specific to promoted portfolio using Lundbeck resources. Utilize deep understanding of Medicare payer landscape in addition to other payer channels including … more
- Molina Healthcare (Long Beach, CA)
- …the medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid , NCQA and other regulatory requirements. + Reviews quality ... Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare . **PREFERRED EDUCATION:** Master's in Business Administration,… more
- PruittHealth (Charlotte Hall, MD)
- …home and methods of payment for those services including but not limited to Medicare , Medicaid , insurance and private pay 3. Verifies accuracy of patient ... file 4. Updates/maintains accurate daily census 5. Responsible for accurately reporting daily nursing hours 6. Makes daily deposits and records in a timely manner;… more
- State of Georgia (Fulton County, GA)
- …+ Obtains and maintains comprehensive knowledge of operations and reimbursement policies of Medicare and Medicaid programs. + Works with investigative team to ... Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/52416/other-jobs-matching/location-only) Hot… more
- Elevance Health (Buffalo, NY)
- …processes. + Monitors and reports quality measures per state, Centers for Medicare and Medicaid Services (CMS), and accrediting requirements. **Minimum ... ** Medicaid Quality Management Director** Location: This position will...BA/BS in a clinical or health care field (ie nursing , epidemiology, health sciences) and a minimum 5 years… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- …and Medicare Secondary Payer claims for accuracy and timely submission per Medicare , Commercial, and Medicaid billing guidelines + Submission of Medicare ... on unpaid claims and document account within standard billing cycle time frame ( Medicare : 16 days after submission , Commercial/ Medicaid Coinsurance: 14-21 days… more
- Fairview Health Services (Edina, MN)
- …Services (DHS), the Minnesota Department of Health (MDH) and the Centers for Medicare and Medicaid Services (CMS). This position will serve Fairview Partners ... according to MCO, Minnesota Department of Human Services (DHS) and Centers for Medicare & Medicaid Services (CMS) guidelines + Performs additional clinical… more
- Sanford Health (SD)
- …guidance and support to all operating segments across Sanford. Responsible to review Medicare / Medicaid documentation to assist nursing centers in completing ... minimum data set (MDS) documentation to assure appropriate levels of Medicare and/or Medicaid reimbursement. Works with executive leadership, administrators, and… more
- Fairview Health Services (Princeton, MN)
- …Services (DHS), the Minnesota Department of Health (MDH) and the Centers for Medicare and Medicaid Services (CMS). **Job Expectations:** Assessment + Conducts ... according to MCO, Minnesota Department of Human Services (DHS) and Centers for Medicare & Medicaid Services (CMS) guidelines + Performs additional clinical… more
- Fairview Health Services (Princeton, MN)
- …Services (DHS), the Minnesota Department of Health (MDH) and the Centers for Medicare and Medicaid Services (CMS). **Job Expectations:** Assessment + Conducts ... according to MCO, Minnesota Department of Human Services (DHS) and Centers for Medicare & Medicaid Services (CMS) guidelines + Performs additional clinical… more
- Centers Plan for Healthy Living (Margate, FL)
- …responsible for the review of the admission, resumption, recert and discharge assessments for Medicare , Medicaid , Medicare / Medicaid HMO cases to ensure ... team Qualifications + Graduate from an accredited School of Nursing . + 3-5 years of home care experience +...home care experience + Strong knowledge of OASIS and Medicare / Medicaid guidelines + OASIS and or Coding… more
- Signature Healthcare (Owensboro, KY)
- … facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... Resident Assessment Instrument (RAI), Prospective Payment Systems (PPS), Quality Measures (QM's), Medicaid Casemix and Medicare / Medicaid guidelines for all… more
- Humana (Richmond, IN)
- …home diversion or long-term care case management experience + Prior experience with Medicare & Medicaid recipients + Experience working with a geriatric ... + Perform job responsibility in Indiana + Licensed Registered Nurse (RN) in the state of Indiana without restrictions...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Columbus, OH)
- …benefits organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, ... reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest...leveraging core consulting skills to support delivering some of Medicare and Medicaid 's highest priority projects and… more
- Central Maine Medical Center (Lewiston, ME)
- …patients for discharge planning and utilization review. This includes those who may have Medicare , Medicaid , HMO, or private insurance to cover their stay at ... various units. Discharge planning is coordinated with physicians, nursing , patients, and significant others who have an ongoing...discharge planning in addition to knowledge of criteria for Medicare , Medicaid coverage and that of HMO… more
- Wesley Enhanced Living (Warminster, PA)
- …in Long Term Care (LTC) billing with knowledge of Point Click Care, medicare , medicaid , and third party billing for skilled nursing homes. + Long Term Care ... collection of account receivables for a group of skilled nursing facility and a central billing environment, within the...primary, secondary and private co-pays. + Coinsurance billing for Medicare A & B + Private collections Medicaid… more
- New York State Civil Service (Buffalo, NY)
- …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... participate to the degree necessary to allow for your services to be billed through Medicare and Medicaid . If you are appointed and lose the ability to bill… more
- The New Jewish Home (Manhattan, NY)
- …Knowledge and proficiency with computer and other office equipment 3. Knowledge of Medicare , Medicaid , Managed Care, Social Security and other entitlement and ... area so that files are easily accessible 26. Follow Nursing Home policies and procedures 27. Assist with weaning...3. Minimum 2 years Supervisory experience 4. Knowledge of Medicare , Medicaid and Third party billing 5.… more
- State of Georgia (Fulton County, GA)
- …for Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator- Medicaid Fraud Division *To move forward in the recruiting ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only)... Program; state and federal laws and policies governing Medicare and Medicaid . + Applies appropriate regulations,… more
