- Humana (Nashville, TN)
- …Based Services, Medicaid and Medicare integration, D-SNPs, and Self-Directed Services. The Capture Lead , Medicaid Clinical & Population Health ... put health first** Humana Healthy Horizons is seeking a Capture Lead , Clinical & Population...clients and populations served in target growth markets. The Lead , Medicaid Clinical & Population… more
- Humana (Annapolis, MD)
- …(MA) and Special Needs Plan (SNP) populations that benefit from payer led clinical services. This role will focus on opportunities to improve member health outcomes, ... member and provider experience, clinical quality, and savings to medical costs. The Strategy...quality, cost, and experience for members and providers + Lead cross-functional teams to define discrete opportunities that are… more
- Sevita (Baltimore, MD)
- …Coordinates and executes pre- and post-payment audits of medical records and associated clinical documentation to ensure proper charge capture and billing in ... the United States. Our extraordinary team offers innovative, quality services and support that lead to growth and new opportunities for the people we serve and for… more
- Commonwealth Care Alliance (Boston, MA)
- …is Important to Us:** Please Note: This position will primarily be focused on Clinical Healthcare projects.** We seek an experienced Agile Scrum Master to join our ... processes, software systems, and technology platforms that support Medicare and Medicaid Health Plans. **Supervision Exercised:** No, this position does not have… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Clinical Strategy team is a multi-disciplinary team focused on creating data-driven strategies to ... reducing unnecessary costs from the healthcare system. The Utilization Management Strategy Lead role works closely with internal and external stakeholders, such as … more
- The Mount Sinai Health System (New York, NY)
- …of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access Coordinator Lead supervises ... Financial Access Coordinator staff and interacts with clinical employees on multiple levels, including pharmacists, nurses, medical/...are inherent to the success of this position. The Lead is primarily responsible for, but not limited to,… more
- Humana (Louisville, KY)
- …our caring community and help us put health first** The Business Intelligence Lead solves complex business problems and issues using data from internal and external ... sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity ranging from moderate to substantial.… more
- University of Michigan (Ann Arbor, MI)
- …Ability to navigate the EHR to identify documents for review to provide accurate capture of clinical information. + Knowledge and understanding of third party ... is responsible for accurate, and timely diagnosis and procedure coding, charge capture , and abstracting of all required data elements from the patient medical… more
- Trinity Health (Silver Spring, MD)
- …using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **Responsibilities:** + Monitors accuracy of centralized coders' charge ... capture and coding with proper ICD-10, CPTs, as well...of ICD-10, CPT, and HCPCs modifiers. Knowledge of Medicare, Medicaid , and other third-party billing rules and regulations. +… more
- Mohawk Valley Health System (Utica, NY)
- …staff to facilitate accurate and complete documentation for coding and abstracting of clinical data for: capture of severity, acuity and risk of mortality ... potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals… more