- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Under direction of the Director of Medicare Compliance , the primary focus areas of this position include development and ... to regulators + Submit materials to regulators + Coordinate attestations from Senior Leadership for submission ** Compliance Regulatory Guidance Distribution** +… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …to fulfill the goals and objectives of the Medicare Advantage Compliance Program, in collaboration with senior management and stakeholders. Plan, execute, ... reports to this job: Director, Medicare Advantage Compliance & Medicare Compliance Officer...**Work Experience** + 7 years Previous experience as a senior compliance consultant or similar role with… more
- CVS Health (Buffalo Grove, IL)
- …to make health care more personal, convenient and affordable. Position Summary The Sr . Clinical Pharmacist, Medicare - Medical Affairs leads within the Medical ... Affairs and key stakeholders across the organization to support customer needs. The Sr . Clinical Pharmacist, Medicare - Medical Affairs is responsible for… more
- Omnicell, Inc. (Fort Worth, TX)
- ** Sr . Manager , Pharmacy Operations Compliance - Remote ** The Sr . Manager , Pharmacy Operations Compliance is responsible for tracking, ... and regulations, Joint Commission (JC) accreditation standards, and Centers for Medicare and Medicaid (CMS) Conditions of Participation relative to the practice… more
- Commonwealth Care Alliance (Boston, MA)
- … (CHC) preferred + 5 or more years direct work experience inregulatory affairs and/or compliance in Medicare or Medicaid required + 5 or more years of managerial ... Role is Important to Us:** Under direction of the Sr . Director of Regulatory & External Audits, the primary...external regulatory agencies including but limited to Centers for Medicare & Medicaid Services (CMS), Mass Health, Departments of… more
- Molina Healthcare (Las Vegas, NV)
- …health plan and requires experience within that space. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions / QI Compliance contributes to ... direction and implementation of **NCQA accreditation surveys** and federal/state QI compliance activities. This position focuses on **Quality Compliance ** for… more
- Molina Healthcare (Las Vegas, NV)
- …and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality ... more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-, program-, and… more
- CareOregon (Portland, OR)
- Job Title Sr Accountant Department 3006 - Finance Exemption Status Exempt Requisition # 24296 Direct Reports n/a Manager Title Accounting Operations Manager ... Portland, Oregon or SW Washington. Job Summary This position performs senior level accounting functions for the organization. Primary responsibilities include… more
- Commonwealth Care Alliance (Boston, MA)
- …Partner with Senior Director of Operations, and Paramedic Network Delivery Manager around medic performance and periodic trainings and/or case reviews. + Oversee ... unnecessary ED visits 88% of the time** . The Sr . Medical Director, InstED is a key clinical leader...presentation and/or media opportunities. + As backup to the Senior Director of Operations, Customer Support Manager ,… more
- University of Miami (Miami, FL)
- …Time, Manager , Facilities & Operations to work at UHealth. The Senior Manager , Facilities & Operations administers leadership for various projects, programs, ... satellite practices and leased facilities for continuous and ongoing compliance with the Center of Medicare &...each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're… more
- Waystar (Salt Lake City, UT)
- **ABOUT THIS POSITION** Waystar is seeking a smart and creative Senior Product Manager with hands on experience in Healthcare Revenue Cycle Management. We are ... closely with User Experience team and Technology teams. The Senior Product Manager will lead cross departmental...industry standards and staying up-to-date on industry changes and compliance issues + Gathering inspiration and ideas by visiting… more
- Access Dubuque (Dubuque, IA)
- …department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... Staff Accountant Sr -Financial Plan **UnityPoint Health Finley Hospital** 1 Positions...Overview** **Overview** Reporting to the VNA Director, the VNA Senior Staff Accountant provides all financial oversight of VNA… more
- UNC Health Care (Chapel Hill, NC)
- …health and well-being of the unique communities we serve. Summary: The Prosethetist Sr is a health care professional specifically educated and trained to manage ... by the prosthetist /orthotist. Implements changes with DMEPOS standards and Medicare policies. Oversees inventory, including ordering new stock as warranted by… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **37429BR** **Extended Job Title:** Sr Medical Billing Associate (MPIP/Alberta) **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** ... to process patient and/or insurance refunds for the Institutional Office of Compliance and/or Audit Services timely and accurately as defined by their audit… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... are not limited to utilization review, hospital reimbursement, clinical compliance , case management, and transitions of care, as outlined...documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate… more
- Healthfirst (NY)
- …Local Coverage Determinations Preferred Qualifications: Bachelors degree Knowledge of compliance and regulatory guidance/regulations across the Medicaid, Medicare ... Director and/or UM Clinical Director requests. Collaborate with the Regulatory, Compliance , Legal and Clinical departments to ensure deliverables adhere to local,… more
- Commonwealth Care Alliance (Boston, MA)
- …Department Regulatory Affairs and Compliance infrastructure at CCA. + Promote compliance in CCA's business operations with all Medicare and Medicaid ... Program + Contribute towards the maintenance and enhancement of an effective Compliance Monitoring Program + Contribute towards the maintenance and enhancement of an… more
- Molina Healthcare (Albuquerque, NM)
- …and monitoring for key performance measurement activities. **Knowledge/Skills/Abilities** The Senior Specialist, Provider Engagement contributes to one or more of ... interventions (eg, removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities. *… more
- CTG (CA)
- …and a thorough understanding of customer service best practices in the healthcare Medicare Advantage industry. As the Customer Service Manager , you will be ... protected classes. Submit a referral to this job (https://usjobs-ctg.icims.com/jobs/10669/ medicare -advantage-plan-call-center- manager /job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834384795) **ID** _2024-10669_ **Title** _Medicare Advantage… more
- Healthfirst (NY)
- …healthcare agency Knowledgeable of Department of Health (DOH) and Center for Medicare & Medicaid Services (CMS) regulations Compliance & Regulatory ... all the enabling tools and technology (software and hardware) that support the Medicare Sales and Retention team Works with internal and external constituents as… more