- Erickson Senior Living (Baltimore, MD)
- …This person will collect and analyze data from multiple sources to ensure regulatory compliance . How you will make an impact: Review the OASIS submitted by the ... coding, developments, changes, and regulations set forth by the Centers for Medicare and Medicaid Services (CMS). Safeguard the confidentiality of medical records in… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …accurately forecast gross to net components including but not limited to Managed Care, and Medicare Part D , Medicaid as well as current and future Healthcare ... data sources used in analyses, generating new insights Controls, Compliance and Finance Responsible for ensuring that all rebate...key rebate categories included but not limited to Commercial, Medicare Part D , Coverage Gap,… more
- Yale New Haven Health (Manchester, CT)
- Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - ... nursing assistants, residents, families and physicians. c. assumes responsibility for compliance with Federal, State and local regulations within the assigned unit.… more
- Jazz Pharmaceuticals (Pittsburgh, PA)
- …(HIPAA regulations), product reimbursement and product access Knowledge and experience in Medicare Parts A- D , Medicaid, and private payer policies, reimbursement ... join our team. If you're looking to be a part of a company with an unwavering commitment to...reviews, and issue resolution. Monitor service level agreements (SLAs), compliance , and operational efficiency. Define, track, and analyze key… more
- US Tech Solutions (May, OK)
- …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... contract **Note:** + Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience. + **Shift… more
- US Tech Solutions (May, OK)
- …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- US Tech Solutions (AZ)
- …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. **Position Summary** The Divisional CFO for Medicare Part D and Medicare Supplement is responsible for the ... financial stewardship, regulatory compliance , and strategic direction of these two major business...+ Serve as the chief financial partner to the Medicare Part D and … more
- Prime Therapeutics (Salem, OR)
- …cost effective delivery of service; design, develop, and implement annual operating budget and the Medicare Part D annual bid + Partner with stakeholders and ... objectives are met and/or exceeded; instill a culture of compliance , accountability, and superior service within the Government Programs...and recognition for government program expertise; strong understanding of Medicare Part C and D … more
- Humana (Jacksonville, FL)
- …must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work ... **Become a part of our caring community and help us...The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,… more
- BrightSpring Health Services (Bowling Green, KY)
- …the benefits of Original Medicare (Parts A and B) with prescription drug coverage ( Part D ). The Abilis Health Plan is a unique plan allowing members to ... approved sales and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and standards. + Conduct… more
- Centene Corporation (Austin, TX)
- …knowledge of compliance laws and regulations, specifically related to Medicare , D -SNP, and applicable state regulations._** **Position Purpose:** Partners ... and SMAC regulatory filings. + Manages Duals (and Medicare with D -DSNP specific or separate) compliance reporting responsibilities and respond to inquiries… more
- Centene Corporation (Austin, TX)
- …and delivering compliance training and education required + Experience with D -SNP SMAC, regulatory requirements and/or operations required + Medicare managed ... candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with… more
- Northwell Health (Westbury, NY)
- …coding rules and regulations to the validation review process. + Reviews codes on Medicare /non- Medicare charts for compliance to rules and conventions. + ... Seeking RN - BSN or MSN candidates with a HCS- D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for...the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards… more
- Atlantic Health System (Morristown, NJ)
- …organizational privacy, information governance, and data risk classification; (iv) accountable care organization compliance ; (v) Medicare C & D / Medicare ... Compliance and Privacy Manager oversees, in pertinent part , the following compliance risk areas: (i)... Compliance guidance and regulatory requirements; and (vi) Medicare C & D / Medicare Advantage… more
- LA Care Health Plan (Los Angeles, CA)
- …care. Ability to prioritize caseload. Knowledge of community resources. Knowledge of Medi-Cal and Medicare regulations. Ability to work as a part of a diverse ... Care Management Specialist II, D -SNP Team (12 month Assignment) Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position… more
- Trinity Health (Gaithersburg, MD)
- …correct CMS return files, RAPS, and encounter data. + Ensure compliance with Medicare Part D reporting requirements and prepare annual bid submissions. + ... Health PACE (TH PACE) programs. This role manages revenue cycles for Medicare , Medicaid, and private pay, oversees expense cycles including vendors and medical… more
- Prime Therapeutics (Jefferson City, MO)
- …(CHC) + Advanced degree in related area of study, such as Juris Doctor + Medicare Part D , Medicaid, and/or Affordable Care Act knowledge and experience ... career? Come build the future of pharmacy with us. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is… more
- Prime Therapeutics (Boston, MA)
- …(CHC) + Advanced degree in related area of study, such as Juris Doctor + Medicare Part D , Medicaid, and/or Affordable Care Act knowledge and experience ... fuels our passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The … more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …play a pivotal role in monitoring Medicare Advantage Part C and D claims to ensure accuracy, integrity, and compliance across the board\. Our **Senior ... your next big career move as one of our compliance champions\! With your strong background in claims processing,...to work independently under general supervision and collaboratively as part of a team in a fast paced environment… more
