Job Alert: Virtual Auditor Medical Coding

Virtual, minimal travel, international company with accelerated career opportunities!

This is what awaits the Medical Coding Auditor.   You are a top technical coding expert looking to represent a leading international company assisting them with their hospital and physician practice clients as a first level coding auditor and trainer.  Your experience in ICD-9, ICD-10, CPT coding, HCPCS, and DRG assignments will be vital in this role.  While working with clients you be provide ongoing education to their coders, physicians, and other clinical staff.  Almost all your work will be done remotely from your home office with only 15% to 20% of your time traveling.

Are you interested? Interview today by clicking on this link.

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Pioneer ACO’s- A 2013 Update


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Search: Medical Director | Informatics Focused

More than EHR Implementation…

The Medical Director, Health Care Informatics is a forward thinking, tech savvy physician executive. Charged with leading this 55,000 member Medicare health plan into the next level of Informatics sophistication, the Medical Director will, among other things, be responsible for…

– High powered outcomes projects in association with Tulane and LSU
– Being the bridge from the health plan to the physician offices
– Champion IT, Decision Support, and Medical Affairs
– Assisting the VP of Informatics to bridge the clinical gap
– Interacting with peers across the country to bring back best practices
– Mentor Market Medical Directors and Clinical Pharmacists
– Articulate the benefits of EHR adoption to the physician community

Looking to sit in your office and review charts? This is not the job for you! The Medical Director is expected to out in the various company departments, meeting with providers, vendors, and community. This role will be driving enterprise wide change and requires someone who is very report and informatics driven. Results oriented executives will never be bored at Peoples Health.

Medical Director will work from the Corporate offices in Metairie, LA. Metairie is the first suburb of New Orleans, LA, located on the south shore of Lake Pontchartrain between the cities of New Orleans and Kenner. Metairie is also home to the Saints offices and practice fields and just a short drive to the French Quarter, Superdome, Aquarium, Zoo, and Convention Center. Over 30 private and 50+ public schools are located in Metairie.


Apply Here

ABOUT THE COMPANY
Peoples Health has retained MMS Group for this search. Peoples Health is a caring company, totally integrated into the community. They are first a member centric health plan, well respected, not complacent and known as a forward thinking, cutting edge managed care company. You’ll join a strong group of professionals who are passionately engaged in their projects and programs.

The Next Step – Medicaid ACOs?

“Leading-edge state Medicaid agencies across the country are exploring the potential of accountable care organizations (ACOs)”

Kip Piper, in The Piper Report, outlines the 10 Core Considerations for Implementing Medicaid ACOs. It is an excellent look at the initial steps needed this if it is to become a reality.

Medicaid ACOs deserve a look. We are in a climate where it is politically unpalatable to “cut” Medicaid funding, yet we are going to be hard pressed to find all the money needed. The difference, as Piper points out, has to be from improvements in quality, delivery, and cost-efficiency. Even though the jury is still deliberating on the overall impact of ACOs, why not test this in Medicaid?

As we  move forward with Medicaid expansion, innovation and risk taking will be what pushes us to achieve Medicaid’s overall goals. Just the fact that Medicaid ACOs are being considered demonstrates the drive toward doing things differently. How this all shakes out is still a mystery. What is known is that a new way for everything in Medicaid is the kind of reform that needs more focus.

~ Richard Yadon

“A day that will live in infamy”

The Legacy of Pearl Harbor Can Be Found Again

While in the Navy, I had the pleasure of serving for several months on Ford Island, located in the middle of Pearl Harbor.  Each morning I looked out the window of my barracks and enjoyed the beauty of the Oahu.  I couldn’t miss the Arizona Memorial just a few yards away from the shoreline of the island.  On several occasions I took the boat out to the memorial.  It is typically a silent ride across the harbor, most of the tourist on the boat realized the solemn and sacred nature of our destination.

The silence continues on the memorial itself, interrupted only by hush whispers between visitors or the click of a camera.  The full magnitude of the Attack becomes more real when you read the names of those who were lost.  There is an eeriness in peering over the side of the memorial to see the shape of the Arizona there just below the surface of the harbor.  If you have not seen a battleship up close it is hard to realize the sheer size of the vessel.  Yet there clear water is her slowly rusting  hulk, the tomb of so many sailors taken by surprise on the December morning in 1941.

In the 71 years that have passed since the attack at Pearl Harbor the significance and sacrifice of that day has waned.   Few of us reading this were even alive when it happened.  Yet that does not change our need to continually remember and honor the men and women who died on this day.

December 7, 1941 is a dividing line in American history.  In a very short time our country went from being a third-rate military power to being the greatest military and economic power on earth.  This is the legacy we have inherited.  The people of that time-honored the sacrifice of the those lost and injured at Pearl Harbor by joining together.  Our entire country rallied to a common purpose and set aside their lives to achieve a common victory.

It doesn’t seem like that could happen today.  We are far too interested in our own self-serving purposes and our own victories to unite for a common good of the nation.  Where once this was our greatest strength, this lack of unity is now our greatest weakness.

If we are to truly honor Pearl Harbor Day let’s begin by thinking about our common purpose and start living and working to achieve a common victory.  That is the America that Pearl Harbor created.

Where will the Medicaid dollars come from?

The Debate is Finally Getting Around to Reform

This is one of the most persistent questions being asked today. If ACA is here to stay AND if Medicaid is going to expand, how do we pay for it? One answer has been to increase tax revenues on the wealthiest Americans. While this has become a popular sentiment, it is more of a political statement then any meaningful enhancement to revenue.

The real answer to the question seems to be coming around to the need for true reform; reform in how we fund Medicaid, in how we reimburse providers, and in how we deliver care to Medicaid members. The money debate has moved on from whether ACA and Medicaid expansion should be done, but in how it will be implemented.

In a recent post on The Health Care Blog, writer Dan Diamond illustrates this shift in focus by describing the change in tone from Florida Governor Rick Scott.  Scott, a staunch opponent of ACA and Medicaid expansion, is described in the post as begrudgingly implementing ACA. It is a dramatic example of how the momentum has swept the issue into a new pool of discussion and thought.

If we were designing a health-reform agenda from scratch, what would it look like?” ~ Avik Roy in National Review (Click to tweet this)

I view this development as the right next step. However, it will be the private sector that has to lead. We can’t generate enough funding to do everything for everyone in Medicaid. The shortfall will need to come from innovation, efficiency and improved health outcomes. The private sector has already been working hard on this and building new ways to meet the demand, and reality, of health care delivery in the post-ACA world. If government can finally agree on the framework, then I believe the private sector can find a way to make it happen.

A better way does not have to be more expensive. The Affordable Care Act is not perfect. It has a lot of flaws that may actually do more harm than good.  At least  now we are talking about what it was intended to do; reform how we deliver health care.

 

~ Richard Yadon

Top 10 Reasons to Attend the Medicaid Innovations Conference

Top 10 Reasons to Attend this Year’s Medicaid Innovations Forum

 

Plus $200 Off – Use Code MMTS

 

 

 
 
 

  1. Arkansas Department of Human Services will offer a unique case study about their Healthcare Payment Improvement Initiative, focusing on how they are Aligning Payment Incentives for Delivery of High Quality Coordinated Care.
  2. Leaders from EmblemHealth and UnitedHealthcare will discuss Health Insurance Exchanges and Shifting Thinking from Medicaid to Commercial Operations.
  3. Minnesota and Colorado share their first-hand perspectives on establishing an ACO within their Medicaid programs.
  4. Wellpoint will share the key components of the quality initiative that resulted in improved HEDIS scores including promoting preventive care, encouraging and rewarding best practices, creating a lever for medical home-based care, and improving data capture.
  5. Missouri Department of Social Services will address Preventing and Detecting Fraud and Abuse in Medicaid Managed Care Organizations.
  6. L.A. Care will disclose their community partnership approach to reducing unnecessary ER visits and preventable readmissions and Ohio offers the state perspective on reducing ER visits among Medicaid beneficiaries.
  7. The Department of Vermont Health Access will explore the challenges of expansion, and the plan to launch a single, universal payer system.
  8. UnitedHealth Group, the State of Michigan, and CareSource offer their unique strategies for consumer engagement.
  9. EmblemHealth shares how they are preparing for the challenge and opportunity of dual eligible integrated care programs.
  10. UPMC Health Plan will deliver a case study on how they are supporting the Patient Centered Medical Home in Medicaid and CareSource discusses their bridge to home discharge planning program.
To see the agenda, visit http://www.medicaidinnovations.com

Technology Trends in Medicaid

Did you miss last week’s Medicaid Matters Talk Show? Richard Yadon, show host interviewed Gwen Williams VP of Molina Medicaid about the latest trends driving the Medicaid eco-system forward toward 2013. Ms. Williams currently serves as the Chairwomen of the Private Sector Technology Group. Learn more about the PSTG by clicking here.

Listen in to the Medicaid Matters show recording below:


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Pausing the day to reflect and remember….

Today we like most of our fellow citizens, pause and reflect on the events of September 11, 2001. It is hard to believe it has been 11 years. While it would be hard for me to recall what I had for lunch yesterday, I can tell you exactly where I was and what I was doing on this day eleven years ago. Do you remember what the top news story was on that day? It was about the scandalous speculation that a congressman was implicated in the murder of a missing intern. What seemed so important on that day has almost been all but lost.

What happened eleven years ago taught us to put things in perspective. For a time we were a country were united in our patriotism, our faith, and we saw ourselves as one people. Unfortunately that spirit has been lost as time passed. Today we are even more divided than we were before. I am not suggesting the issues of today are not important, however, we now use those issues to create an ‘us versus them’ environment. Where has the day gone when the entire Congress stood on the steps of the Capital and spontaneously sang ‘God Bless America’ together?

As you pause today to consider the events of 9/11 I encourage you to remember the victims, their families, the service members who soon went to war and are still there, and the people who to this very minute are vigilantly protecting our country. I also encourage you to pray, as I will, for them. Let me ask you to also add an additional prayer as well; ask to once again see that spirit that brought us all together in the days and weeks after the attack. Ask for that spirit to stay.

Richard Yadon

Most Admired CEO Nomination- Congratulations to Richard Yadon!

Congratulations to our very own Richard Yadon! He has been nominated for one of the Nashville Business Journal’s 2012 Most Admired CEO and Their Companies Awards presented by Chase in the Institution

Richard Yadon, Host Medicaid Matters Talk Show

Awards and Recognition

The Most Admired CEOs and Their Companies Awards presented by Chase awards the top CEO’s in the city by category.

Black Tie Award Ceremony

It culminates to a black tie awards dinner on December 4th at the Schermerhorn Symphony Center where we will recognize the finalists and one winner in each category, plus a lifetime achievement winner.

Check out the 12/7 Nashville Business Journal

In addition to the awards dinner, finalists and winners will be featured in a special insert in the December 7th issue of the Nashville Business Journal.

Mr. Yadon is the President and founder of Managed Medicaid Services and the host of the Medicaid Matters Talk Show, both of which are located in a suburb of Nashville, TN.

Please join us in congratulating Richard by leaving a comment in the box below this post.