- Bloom Healthcare (Lakewood, CO)
- Job Title: Manager, Medicare Value - Based Programs Location: Denver, Colorado Reports to : Vice President of Innovation About Bloom: Bloom Healthcare is a ... first. Position Overview: Bloom Healthcare is looking for a motivated Manager of Medicare Value - Based Programs to oversee the daily operations of our… more
- CVS Health (Denver, CO)
- …+ Key concepts (high level) of provider networks as they pertain to Medicare Advantage products (contracting, adequacy, value - based payment models) **Skills ... oversee and manage complex projects in support of Government Programs Network team's process, operations, and strategy as it...CVS Care Delivery assets, and resides within the Network Value Based Solutions and Analytics Organization. This… more
- Humana (Denver, CO)
- …etc. + Creates data models to attribute members to providers for new value - based programs and to evaluate program effectiveness. + Ensures data integrity ... in program administration for new value - based programs . + Troubleshoots data...and other data systems. + Experience in Medicaid and/or Medicare managed care. + Experience working with big and… more
- Humana (Denver, CO)
- … that influence providers, members or market leadership towards value - based relationships and/or improved quality metrics. The Program Delivery Lead ... Program Delivery Lead strategically identifies, develops, and implements programs...8+ years of operations experience + 2+ years of program management experience + 2+ Medicare Stars… more
- Prime Therapeutics (Denver, CO)
- …fuels our passion and drives every decision we make. **Job Posting Title** Clinical Program Manager - Remote **Job Description** The Clinical Program Manager is ... responsible for the management of all client specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management … more
- CenterWell (Denver, CO)
- …caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes with ... a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the analysis of… more
- University of Colorado (Aurora, CO)
- …| Addiction Research & Treatment Services (ARTS) | Adult Outpatient Program ** **Job Title: Peer Recovery Specialist - Patient Services** **Position: #00828232 ... improve health outcomes for patients who enter care at ARTS Adult Outpatient Program (AOP) clinic locations in Denver, Arvada, Aurora, and/or the ARTS Medication… more
- Evolent (Denver, CO)
- …people, processes, and technology levers + Contributes to the design of new value - based care programs for oncology, cardiology, and musculoskeletal disease ... resources-such as high- value clinical pathways, electronic decision support and value - based payment models-we create an ecosystem that helps providers… more
- Humana (Denver, CO)
- …and/or other specific healthcare areas such as EMR, Episode grouper, utilization management, value - based care, low value care etc. + Experience managing ... to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries leveraging data science & analytics, clinical expertise, strategic… more
- University of Colorado (Aurora, CO)
- …a Nurse Practitioner or Physician Assistant in the State of Colorado + Medicare /Medicaid credentials + Unrestricted DEA license + Board certified or board eligible ... a Nurse Practitioner or Physician Assistant in the State of Colorado + Medicare /Medicaid credentials. + Unrestricted DEA license + Board certified as a Nurse… more
- AdventHealth (Denver, CO)
- …CMS Conditions of Participation for Discharge Planning + Understanding of Managed Care and Value Based Programs + Sustained goals of Care Management metrics, ... Days Off from Day One + Student Loan Repayment Program + Career Development + Whole Person Wellbeing Resources...Readmission Prevention, Length of Stay, Excess days, Avoidable Days, Value Based Care partnerships, Care Manager's roles… more
- HCA Healthcare (Denver, CO)
- …monitoring and evaluating quality of care for solid organ transplant and associated programs . Direct the activities related to program quality and regulatory ... a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase...programs . Implement and coordinate a continuing staff development program for all direct reports. Support staff and … more
- Highmark Health (Denver, CO)
- … to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- University of Colorado (Aurora, CO)
- …Establish and maintain policies and procedures for the sliding fee discount program . + Negotiate provider service agreements with external affiliates or new partners ... Establish and maintain policies and procedures for the sliding fee discount program . + Negotiate provider service agreements with external affiliates or new partners… more
- Adams County Government (Brighton, CO)
- …and technical work involved in the administration of the Adams County benefit programs , early retiree/ Medicare programs , leave of absence and ADAAA. ... we actively seek and welcome applicants that bring diverse experiences and value inclusion. Cultural Competencies/EEO Adams County is an equal opportunity employer.… more
- Humana (Denver, CO)
- …resources needed and develops schedules to ensure timely completion of initiatives. Leads program execution to deliver longer term business value . Can possess ... to make an impact** **Job Responsibilities:** + Organizes and prioritizes projects, programs , iterations etc. based on EIP strategic roadmap, prioritized… more
- HCA Healthcare (Denver, CO)
- …an organization that invests in you as a(an) Surgery Scheduler? At Healthone Transplant Program , you come first. HCA Healthcare has committed up to $300 million in ... programs to support our incredible team members over the...over the course of three years. **Benefits** Healthone Transplant Program , offers a total rewards package that supports the… more
- HCA Healthcare (Aurora, CO)
- …health, life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at ... a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase...student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program … more
- Prime Therapeutics (Denver, CO)
- …years of comprehensive experience working with Rebate contracts, or within Medicare /Medicaid (eg insurance, government program operations, managed care ... changes in response to guidance from the Centers for Medicare and Medicaid Services (CMS) and other regulatory or...pay for this position ranges from $66,000.00 - $106,000.00 based on experience and skills. Pay range may vary… more
- Evolent (Denver, CO)
- …+ Not under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid, and is not identified as an "excluded ... Energetic and curious with a passion for quality and value in health care- **Required** + Computer Proficiency- **Required**...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more