- Molina Healthcare (Meridian, ID)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- Humana (Boise, ID)
- …a part of our caring community and help us put health first** The Senior Coding Educator will work closely with providers to identify documentation and coding ... in the risk adjustment methodology. This role reports to the Risk Adjustment Manager and will work closely with market operations, finance, and clinical team to… more
- CenterWell (Boise, ID)
- …appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a ... services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. +… more
- CenterWell (Boise, ID)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
- CenterWell (Boise, ID)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CenterWell (Boise, ID)
- …CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group will provide ... , a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group...the state. . Graduate of accredited MD or DO program of accredited university . Board certification or eligible… more
- CenterWell (Boise, ID)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel:… more
- CVS Health (Boise, ID)
- …improve outcomes, manage costs, and offer an unmatched experience for our patients. As a Senior Product Manager , you will be a key leader in our organization, ... have the needed support from specialist. You'll work with senior business and engineering leaders to lead a product...digital health solutions + 4+ years as a Product Manager + Experience with data analytics and core healthcare… more
- CenterWell (Boise, ID)
- …+ Coordinate, review, and analyze documentation and data entry supporting Medicare , Medicaid, and commercial payer requirements to ensure accurate and timely ... requested. + Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures + Participate in special… more
- CenterWell (Boise, ID)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more