- Molina Healthcare (Florence, KY)
- **Job Summary** The Sr . Specialist Member Engagement representative is responsible for monitoring and evaluating member interactions to ensure that the ... members, and manager. + Basic understanding of managed healthcare systems and Medicare . **PREFERRED EDUCATION:** Associate or bachelor's degree in social work, Human… more
- Commonwealth Care Alliance (Boston, MA)
- …This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and oversight ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- Molina Healthcare (South Florida, FL)
- …metrics/Risk Adjustment will receive first consideration.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance ... Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and… more
- Molina Healthcare (NM)
- …and monitoring for key performance measurement activities. **Knowledge/Skills/Abilities** The Senior Specialist , Provider Engagement contributes to one or ... more of these quality improvement functions: * Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and guidance for other… more
- Molina Healthcare (Albuquerque, NM)
- …administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care ... contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting… more
- PruittHealth (Athens, GA)
- …which to conduct outreach activities and maintain calendar of such events. Market Medicare Advantage on-site at senior centers, food pantries, community events ... MACON or ATHENS** **JOB PURPOSE:** The purpose of the Outreach and Enrollment Specialist role for PruittHealth Premier to serve as a licensed insurance agent to… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Prepares and maintains ... around town, just for being a Medical Mutual team member . + The opportunity to earn cash rewards for...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Providence (MT)
- **Description** **Providence is calling a Senior Charge Description Master Specialist who will work remotely within our footprint states, AK, CA, OR, WA, TX, NM, ... or MT.** As a member of the PSJH System Revenue Integrity Chargemaster (RICDM) Dept. team, the Senior CDM Specialist shall ensure that the Chargemaster (CDM)… more
- Medical Mutual of Ohio (OH)
- …records needed for management reporting. + Performs other duties as assigned. ** Sr . Underwriting Administration Specialist ** Based on market segment assignment: ... plan regulations. + Good math skills. + Good customer service skills. ** Sr . Underwriting Administration Specialist ** **Education and Experience** + Associate… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …with projects as directed by management. . Performs other duties as assigned. ** Sr . Claims/Customer Care Specialist - TPA** . Processes routine to complex ... of third-party administration/ancillary products, services, policies, procedures and systems. ** Sr . Claims/Customer Care Specialist - TPA** **Education and… more
- City and County of San Francisco (San Francisco, CA)
- …of structural racism and historical injustices as a fully integrated and collaborative member of San Francisco's Public Health Department. The mission of JHS is to ... structural racism and historical injustices, as a fully integrated and collaborative member of San Francisco's Public Health Department. JHS is responsible for the… more
- Medical Mutual of Ohio (OH)
- …and regulations and communicates changes.** + **Performs other duties as assigned.** ** Senior Compliance & Accreditation Specialist ** + Interprets standards and ... skills with a demonstrated command of grammar, spelling and sentence structure.** ** Senior Compliance & Accreditation Specialist ** **Education and Experience** +… more
- Lancaster General Health (Lancaster, PA)
- …or equivalent required. + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance programs, ie not excluded ... from participation in Medicare , Medicaid or any other federal or state health...punctuation, grammar, diction, and style; using all parts of speech . + Ability to communicate distinctly with appropriate pauses… more
- Johns Hopkins University (Baltimore, MD)
- …departments, revenue cycles, compliance, and others. Prepares reports for the Senior Director, Director, and clinical department leadership regarding the status or ... charges by ensuring compliance with government regulatory guidelines (ie Centers for Medicare & Medicaid Services- CMS conditions of payment) and CPT coding… more
- Medical Mutual of Ohio (OH)
- …Medicare Supplement, and individual plans. **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information Systems ... more junior staff. . Performs other duties as assigned. ** Senior Business Systems Specialist ** Works with management,...around town, just for being a Medical Mutual team member . + The opportunity to earn cash rewards for… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Medicare Supplement, and individual plans. **Responsibilities** **Digital Marketing Specialist I** Executes day-to-day functions related to maintaining the ... (SEO) and website usability best practices and tools under guidance of more senior team members. . Stays current in knowledge of website platform, best practices,… more
- New York State Civil Service (Corinth, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 (NY HELPS) Occupational Category Health Care, Human/Social Services Salary ... limited license/permit option under notes) AND certification by a Member Board of the American Board of Medical Specialties...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- HCA Healthcare (Reston, VA)
- …**Introduction** Do you have the career opportunities as a Medical Collections Specialist you want with your current employer? We have an exciting opportunity ... provider of healthcare services, HCA Healthcare. We are looking for a skilled collections specialist to work Monday-Friday between the hours of 8:30 AM - 5:30 PM… more
- HCA Healthcare (Austin, TX)
- …to join an organization that invests in you as a Lead Business Office Specialist ? At St. David's Austin Area Ambulatory Surgery Center, you come first. HCA ... (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid...We are looking for a dedicated Lead Business Office Specialist like you to be a part of our… more
- Axis (Alpharetta, GA)
- …We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the ... candidates taking part in the selection process. AXIS Capital Claims Compliance Specialist , Claims Shared Services- Job Description AXIS is seeking a Claims Quality… more