- Atrium Health (Charlotte, NC)
- …interprofessional teams, providing leadership and strategic direction for multiple value - based initiatives, including clinical documentation integrity, pre-visit ... updates and testing as appropriate. Demonstrates knowledge and understanding of severity based DRG systems; All-Patient Refined and Medicare Severity (APR-DRG),… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …quality improvement initiatives. Accountable to broad-scale improvement efforts including Hospital value - based incentives (P4P, VBI, VBP, etc.), network-wide CMS ... HEDIS, CAHPS, HOS, P4P and other identified performance measures4. Research evidence- based practices, national and regional benchmarks, and industry standards… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …quality improvement initiatives. Accountable to broad-scale improvement efforts including Hospital value - based incentives (P4P, VBI, VBP, etc.), network-wide CMS ... HEDIS, CAHPS, HOS, P4P and other identified performance measures4. Research evidence- based practices, national and regional benchmarks, and industry standards… more
- The Cigna Group (Scottsdale, AZ)
- …for improving Affordability and Total Cost of Care initiatives as part of the Medicare Business Optimization effort. This role will be a key member of the team ... and deliver results. + Drive fulfillment of affordability commitments for aligned value streams with creation of performance scorecards that show actual vs target… more
- Highmark Health (Charleston, WV)
- …programs. + Directly responsible to analyze and interpret data in government value - based reimbursement reports in the areas of Medicare STARS, Medicaid HEDIS ... outcomes, and engagement of primary care providers (PCP) enrolled in government value - based reimbursement programs and continuous improvement models. This job is… more
- AdventHealth (Altamonte Springs, FL)
- …23007379 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, ... Reimbursement Analyst is responsible for preparing and filing the annual Medicare , Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal… more
- CVS Health (Orlando, FL)
- …not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual ... top sales talent! At CVS/Aetna we are expanding our Medicare Sales team and are looking for candidates who... products. * Identifies and pursues opportunity to cross-sell value -added products such as dental and vision. Required Qualifications… more
- CVS Health (Richmond, VA)
- …not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual ... top sales talent! At CVS/Aetna we are expanding our Medicare Sales team and are looking for candidates who...other community leaders.* Identifies and pursues opportunities to cross-sell value -added products such as dental and vision. * May… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …outlined in Medicare Member Service progression model + Annual raise/bonus based on performance + Opportunities for continued salary growth as skills progress As ... a Member Service Seasonal Advocate for Medicare Markets, your role is one of the most...6:00PM. The schedule patterns for each week can vary based on business needs. However, we are committed to… more
- NORC (Bethesda, MD)
- …, Medicare Parts C & D, and Medicaid policy including ongoing value - based care initiatives. + Monitor and oversee the financial and administrative aspects ... Principal Research Scientist - Health Care Program Integrity and Oversight: Medicare & Medicaid Programs Job no: 502272 Work type: Regular Full-Time Location:… more
- CVS Health (Jackson, MS)
- …improving risk adjustment accuracy by partnering closely with leadership from our key value - based providers. The role drives, in collaboration with the ... working in provider offices, accountable care organizations and / or value - based provider relations* Strong time management, project management, change… more
- Medical Mutual of Ohio (OH)
- …concurrent, and retrospective reviews in collaboration with physician reviewers. Applies evidence- based discharge planning so that patients have a safe and timely ... at home. **Responsibilities** + Evaluates clinical information using established national decision support criteria, company policies, and individual patient… more
- CVS Health (Atlanta, GA)
- …working in provider offices, accountable care organizations and / or value - based provider relations* Strong time management, project management, change ... not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual… more
- Humana (Columbus, OH)
- …long-term projection of expenses + Partner with team members to analyze long-term financial value of various member cohorts to drive maximum financial value to ... general ledger data and working with Essbase/Smart View + Medicare Supplement experience **Additional Information** The workstyle for this...posting. The pay range may be higher or lower based on geographic location and individual pay will vary… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Medicare Health Plan Operations Specialist - Remote **Job Description** The Associate Functional ... healthcare experience + Experience using queries + Experience with Medicare Part D **Minimum Physical Job Requirements** + Occasional...pay for this position ranges from $85,600.00 - $128,400.00 based on experience and skills. Pay range may vary… more
- The Cigna Group (Baltimore, MD)
- …health plan. + Educating providers on the performance requirements associated with value - based contracts. + Conducting regular provider visits to educate ... All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: + Growing the… more
- Elevance Health (Richmond, VA)
- …with payment innovation on clinical programs that support providers in value - based payment arrangements. Serves as a subject matter expert/collaborator ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...role will work on Cost of Care, trend management, value - based care support for STARS/HEDIS and correct… more
- The Cigna Group (Birmingham, AL)
- …**RESPONSIBILITIES** + Manages contracting and negotiations for fee for service and value - based reimbursements with hospitals and other providers (eg, Hospital ... groups). + Builds relationships that nurture provider partnerships and seeks broader value - based business opportunities to support the local market strategy. +… more
- Cleveland Clinic (Cleveland, OH)
- …Care, Value Based Contracts, Value Based Performance, Value Based Program, Medicaid, Medicare , Population Health Pay Range Minimum hourly: ... organizations in the world. As part of the CCHS Value Based Performance team, the Program Manager...CCF Hospitals, as well as external teams from various national and regional payor stakeholders to achieve the Triple… more
- Universal Health Services (Reno, NV)
- …or related field preferred. + At least 5 years of health care experience working with value based Medicare Advantage STARS/HEDIS programs. + At least 3 years ... Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage, Accountable Care Organizations, and...be Riverside Medical Clinic and the advancement of its value based MSO strategy. The objective of… more
