- Novo Nordisk Inc. (Dayton, OH)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Pre-Call Planning Creates Customer Engagement-Open Purposefully, Uncover Needs Adapts Approach- Provide Solutions and Deliver Core Messages, Resolve Objections Call… more
- COOLSOFT (Columbia, SC)
- …Analyst Job location in Columbia, SC Skills required Commercial Healthcare, State Medicaid Payer System Integration, MITA, Data Structures Electronic Data ... type Email Recruiter:coolsoft Job Description Analyst: Commercial Healthcare, State Medicaid Payer System Integration, MITA, Data Structures...: The South Carolina Department of Health & Human Services (SCDHHS) is the State Medicaid Agency… more
- Novo Nordisk Inc. (Salinas, CA)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Pre-Call Planning Creates Customer Engagement-Open Purposefully, Uncover Needs Adapts Approach- Provide Solutions and Deliver Core Messages, Resolve Objections Call… more
- National Health Care Associates (Stafford Springs, CT)
- …We invite you to join our team! **-** **What You'll Do:** As a Medicaid Specialist, you will support the center's business office in processing Medicaid ... to the financial stability of our organization, ensuring resources are optimized to provide the best care for our residents. **Key Responsibilities:** + Process and… more
- NORC (Washington, DC)
- …design, methodology, data analysis, and interpretation for Medicare and Medicaid demonstration evaluations and health services research. + Leading teams ... of health care payment and delivery interventions on outcomes and cost using data files derived from Medicare, Medicaid , and commercial payer administrative … more
- Commonwealth Care Alliance (Boston, MA)
- … provider performance, identify opportunities for improvement, and facilitate data -driven action plans. + Collaborate with Contracting, Quality Analytics, and ... quality performance data into actionable insights and communicate findings to provider partners to drive improvement. + Support the development and oversight of … more
- Commonwealth Care Alliance (Boston, MA)
- …teams as needed. Performance and Data Insight - Analyze and interpret provider data related to utilization, cost, quality, and outcomes to identify ... performance. - Develop and execute annual provider engagement plans informed by provider data , feedback, and CCA priorities. - Follow through on performance… more
- Commonwealth Care Alliance (Boston, MA)
- …for escalated provider matters. This position partners closely with provider engagement, delegation partnerships, provider services , contracting, ... systems, large medical groups, and specialty care networks. - Experience supporting provider data integrity, onboarding, and credentialing processes. - Proven… more
- Human Development Services of Westchester, Inc (Port Chester, NY)
- …(HUD) approved Local Housing Counseling Agency in 2006, the NPC has expanded services to provide housing counseling to residents throughout Westchester County, ... to meet funding requirements in completing reports and collecting data as required, and to represent the agency as...in client, financial, and quality metrics. The attorney will provide legal services for eviction proceedings, serving… more
- Commonwealth Care Alliance (Boston, MA)
- …executing communication strategies that foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This ... trends to the committee + Develop and manage annual provider communications schedule + Provide guidance and...brand standards, and provider -friendly + Work with provider network and data management to influence… more
- Commonwealth Care Alliance (Boston, MA)
- …with cross-functional teams (eg, Claims, Credentialing, Clinical Care Management, Member Services , Provider Services , Regulatory Affairs, Marketing) to ... provider engagement strategy, focused on delivering a best-in-class provider experience. + Utilize strategic planning and data -driven insights… more
- Commonwealth Care Alliance (Boston, MA)
- …3-5 years + Managed Care experience + Experience in health plan provider relations. **Experience (Desired)** + Medicare/ Medicaid experience preferred. + ... 011230 CA- Provider Engagement & Performance **Position Summary** The ...orient providers on CCA's policies related to: Claims and service recovery; Program benefits; Clinical initiatives; Referral and authorization;… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …structured and unstructured data ) and analytics, data management, and data visualization. Understanding of Medicaid programs and related health policy is ... each year. From primary to complex critical care, more than 350 programs and services are offered, each one specially designed for children. The CHLA of the future… more
- Monogram Health (Fort Myers, FL)
- …outcomes in conjunction with the Practice Medical Executives to motivate and provide medical direction in pursuit of evidence based and cost effective, quality ... and Responsibilities Reduce unnecessary episodes of care, including hospital readmissions Analyze data built by Practice Medical Executives and ensure care goals are… more
- AdaptHealth LLC (North Port, FL)
- …be able to drive and travel as needed. * Physical and mental ability to provide clinical assessments. * Requires travel throughout service area. * Mental ability ... within the agency and community to accomplish care objectives. This position will provide education and care to the patient and communicate with team, physicians and… more
- DESC (Seattle, WA)
- …no person is abandoned, ignored, or experiencing homelessness. As the region's leading provider of services to multiply disabled adults who have experienced ... member of a multi-disciplinary team that will support DESC's mission by using data queries, creating reports, and providing administrative services for programs… more
- Abt Global Inc. (Rockville, MD)
- …the Information Technology Lead, you will support a large-scale Center for Medicare & Medicaid Services (CMS) project. This role will be contracted through TSPi, ... a subsidiary of Abt Global that provides digital services and solutions to clients. **Core Responsibilities** ** Data...stakeholders to align IT systems with program goals. + Provide technical leadership to ensure IT solutions meet both… more
- NORC (Chicago, IL)
- …+ Expertise with analyzing pharmaceutical utilization and quality outcomes using healthcare data for payor programs including Medicare, Medicaid , and commercial ... care delivery, from private marketplaces and employer-sponsored insurance to Medicare and Medicaid ; from large health care systems to small clinics; and from the… more
- Commonwealth Care Alliance (Boston, MA)
- …as mid-year and annual reviews and program-wide performance summaries. - Support delegated provider staff in using data tools effectively and understanding ... 011230 CA- Provider Engagement & Performance Position Summary: The ...leads performance evaluation and improvement efforts, including reporting and data analysis, to ensure delegated entities meet contractual, regulatory,… more
- Commonwealth Care Alliance (Boston, MA)
- …for relationship management with the contracted community-based organizations (CBOs) that provide service coordination and other supports for CCA members. ... evaluation of the appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a...Agency, GSSC and LTSC, among other details o Coordinate Provider Rosters with the Provider Data… more
