• Medicare Value - Based

    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
    Bloom Healthcare (12/06/24)
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  • Provider Delegation Implementation Senior Project…

    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
    CVS Health (12/18/24)
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  • Value - Based Programs

    Humana (Denver, CO)
    …community and help us put health first** Are you ready for a great job? The Value - Based Programs Analyst 2 supports successful value - based provider ... provider experience and achieving path-to- value goals. The Value - Based Programs Analyst 2 work...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
    Humana (12/21/24)
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  • Managing Director, Value Based Care…

    Evolent (Denver, CO)
    …years of progressive leadership and management experience** **Leadership role within a value based primary care organization (ACO or Managed Services ... Doing:** Evolent is looking for a Managing Director of Value - Based Operations to join our Primary Care...an internal start-up in 2020 with a wholly owned Medicare Shared Savings Program (MSSP) Accountable Care… more
    Evolent (12/13/24)
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  • Value - Based Contracting Lead

    Humana (Denver, CO)
    …Lead requires in-depth understanding of VBP and the contracting process to support value based programs , effective communication, and ability to develop ... community and help us put health first** The Medicaid Value Based Contracts Lead is responsible for...with agreed upon terms + Develop provider letters outlining program details and terms + Develop internal and provider-facing… more
    Humana (12/19/24)
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  • Value - Based Reimbursement…

    Highmark Health (Denver, CO)
    …to understand the current health care delivery state, readiness for change, test value based programming concepts and components, identify key partners, identify ... and private payers. Programs will include but not be limited to pay-for- value programs , episode payments, prospective bundled payments, gain share and risk… more
    Highmark Health (10/10/24)
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  • Stars Program Delivery Lead

    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
    Humana (12/21/24)
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  • Clinical Program Manager - Remote

    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
    Prime Therapeutics (12/18/24)
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  • Senior RX Clinical Programs Pharmacist

    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
    CenterWell (12/14/24)
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  • Peer Recovery Specialist Patient Services

    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
    University of Colorado (12/07/24)
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  • Provider Engagement Executive

    Humana (Denver, CO)
    …health plan. The Provider Engagement Executive is the relationship quarterback to our value - based partners. This team consults and drives results leading to ... 5 or more years of health care or managed care + Experience with value - based care, population health, or other healthcare performance improvement + Proven… more
    Humana (11/21/24)
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  • Chief Clinical Officer

    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
    Evolent (12/21/24)
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  • Lead Research Scientist

    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
    Humana (12/18/24)
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  • Advanced Practice Provider for Virtual Primary…

    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
    University of Colorado (12/06/24)
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  • Director Care Management

    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
    AdventHealth (12/25/24)
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  • Hierarchical Condition Category (HCC) Coding…

    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
    Highmark Health (12/20/24)
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  • Finance & Accounting Assistant Director

    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
    University of Colorado (12/14/24)
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  • Benefits/LOA/ADA Specialist

    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
    Adams County Government (10/20/24)
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  • Lead Business Analyst, Implementation

    Evolent (Denver, CO)
    …driving Evolent's mission, they will play a pivotal role in delivering our value - based strategy with partners and contribute to dynamic initiatives that propel ... flows, use cases, and acceptance criteria for CMS and Commercial programs . + Facilitate communication between business/IT teams, developers, and external… more
    Evolent (10/16/24)
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  • Director, IT Portfolio Management - Enterprise…

    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
    Humana (12/14/24)
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