, and provider data excellence. In an environment of increasing regulatory scrutiny and complexity across Medicare, Medicaid... Leadership Define and lead enterprise network adequacy strategy, ensuring compliance with CMS, state Medicaid, Marketplace...
and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free...
Services, with a strong emphasis on the Centers for Medicare & Medicaid Services (CMS) and other HHS Operating Divisions... CMS opportunities related to Medicare, Medicaid, Marketplace, quality reporting, claims systems, program integrity, data...
(e.g., Medicaid, ACA marketplace, CHIP or government benefit programs) 4. Strong hands on in Pega Case management, File...
, eMAR Understanding of and demonstrated success in achieving and maintaining Medicare/Medicaid standards Excellent...
meet regulatory requirements for Medicare/Medicaid reimbursement. Assist with audits and surveys by providing accurate... preferred. Knowledge of MDS 3.0, RAI process, and Medicare/Medicaid reimbursement guidelines. Strong organizational skills...
as necessary. Maintain knowledge of regulatory standards (TJC, Medicaid, state and federal laws) and ensure compliance. Perform...
systems to ensure correct data entry and reporting. Lead Interdisciplinary Meetings: Attend and coordinate Medicaid, ITTM...
with Medicaid, HHS, rural health, or government-led technology initiatives, including regulatory and compliance frameworks...
. Strong Healthcare domain knowledge of Medicaid, Medicare, and Commercial healthcare data sets. Expertise with normalized OLTP, OLAP, MDM... so they can find the type of candidate you're looking for. Data modeler with Medicaid/Healthcare experience 17. Of the...