- Highmark Health (Charleston, WV)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- CVS Health (Trenton, NJ)
- …Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage withPrescription Drug ... is a Scrum Team role that will be a member of the Medicare / Medicaid Enrollment Configuration team tasked with developing purposebuilt capabilities for our… more
- Northern Light Health (Brewer, ME)
- …and measurements. Additionally, this position will be responsible for all NLH Medicare Advantage or Managed Medicaid and Exchange products. This responsibility ... department and all Northern Light Health Organizations. The Contract Consultant serves as an analytical and process improvement leader....that we all work as a team and the quality and timeliness of work impacts everyone involved. +… more
- CVS Health (Columbus, OH)
- …CPC AAPC or CCA AHIMA certification- 3+ years risk adjustment experience in Medicare advantage or commercial- 3+ years of provider education experience- ... clinical documentation skills to support efforts to improve the overall quality and completeness of clinical documentation in outpatient physician practices.… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... State and Federal laws, regulations, policies and practices for the administration of Medicare Advantage , Prescription Drug Plan, and compliance programs in a… more
- HCA Healthcare (Brentwood, TN)
- …projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models (AAPM); Medicare Advantage ; and commercial payer value programs. This ... projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models; Medicare Advantage ; commercial pay for performance programs, Meaningful… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. The Clinical ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- ChenMed (Miami, FL)
- …departments across the organization and will make data-driven strategy recommendations in the Medicare Advantage and health care industry. With the right mix of ... PowerBI and/or SSRS; statistical modeling. + Experience in health care models including Medicare Advantage Programs and provider risk models preferred. + Prior… more
- Medical Mutual of Ohio (OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans ... in the development and testing of major system modifications. Acts as a consultant to other departments (ie: Training, Benefit Services, etc.) regarding the impact… more
- Scripps Health (San Diego, CA)
- …targets through contract negotiations with Commercial HMO/PPO payers, California Medi-Cal, Medicare Advantage Plans, County Medical Services, TriCare, and other ... partners. Will lead a cross functional teams that have substantial impact on quality , revenue and growth across all Scripps Health business units. The Vice President… more
- ChenMed (Chicago, IL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Louisville, KY)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... demonstrates 1) success in developing providers to deliver high quality , cost-effective care; 2) effective dyad partnership with the...Act as a health coach, rather than just a consultant for sickness, by helping patients set short and… more
- ChenMed (Columbus, OH)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Detroit, MI)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- The Mount Sinai Health System (NJ)
- …Develop standards of care in accordance with The Valley Medical Group's Quality Assurance/ Quality Improvement process **REPORTS TO** **: Chair, Primary ... immunize patients from communicable diseases. 10. Refers patients to specialist for consultant services when necessary for the patient's well being. 11. Physician… more
- ChenMed (Columbia, SC)
- …physicians are true hands-on caregivers transforming the health and lives of seniors on Medicare Advantage . Through our Value Based Care approach, you and your ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Metairie, LA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Richmond, VA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Fort Myers, FL)
- …when leading their care teams towards their performance goals. "IntuneHealth is for Medicare Advantage seniors seeking PCP-led, high- quality care when and ... serves as a health coach, rather than just a consultant for sickness, by helping patients set short and...to ensure compliance with guidelines. Participates in risk and quality management programs, clinical meetings and other meetings that… more