- PharmaCord (Cincinnati, OH)
- …ability to think critically and issue resolution. Knowledge of healthcare compliance regulations, including HIPAA and Medicare/ Medicaid guidelines. Bi-lingual ... reside in the state of Ohio. When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the lives of our patients each… more
- Accessia Health (Midlothian, VA)
- …with ACCESS team to ensure referral for eligible services Conduct benefits investigations With proper consent, direct contact with insurance providers and pharmacy ... payer coverage restrictions while maintaining high quality customer service standards in compliance with federal and state regulations Maintain a repository of payer… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Medicaid Compliance and Investigations Manager ** **Job Class: Human Services Manager 2** **Agency: Human Services Dept** + **Job ... eligible for telework._** **_*Approximately, 10% travel._** The Medicaid Compliance and Investigations Manager is responsible for providing oversight of … more
- Project Renewal, Inc. (New York, NY)
- Title: Senior Manager , Compliance Program: Legal, Varick Headquarters Salary Range: $90,000 - $100,000 per year Overall Responsibilities: The Senior Manager , ... in healthcare and related human services. The Senior Manager , Compliance reports to the Director of...state, and local healthcare regulations (eg, HIPAA, Stark Law, Medicaid /Medicare, Part 2). + Ensure the organization's compliance… more
- Medical Mutual of Ohio (OH)
- …are properly created, implemented, and monitored. + Conducts and/or oversees Medicare compliance reviews and investigations . + Facilitates Medicare Compliance ... leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and Medicare Supplement… more
- Cardinal Health (San Juan, PR)
- …adherence to policies, educates and trains employees across the organization, and conducts investigations to resolve ethics and compliance issues. Ethics & ... of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **_What is… more
- Elevance Health (Columbus, OH)
- ** Compliance Manager ** **Location:** This role requires associates to be in-office 1 - 2 days per week at one of our four Ohio offices (Cincinnati, Columbus, ... for employment, unless an accommodation is granted as required by law. The ** Compliance Manager ** is responsible for managing foundational and strategic … more
- MyFlorida (Fort Lauderdale, FL)
- …Enforcement Investigator II performs work which may include performing all aspects of Medicaid fraud investigations . This work includes but is not limited to, ... civil or criminal judicial proceedings. 65% Conducts routine and complex investigations of possible Medicaid fraud and/or patient abuse, including… more
- Humana (Montpelier, VT)
- …a part of our caring community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of ... approach, resources, schedules and goals. **Where you Come In** The Special Investigations Unit Manager assists coordinating investigation with law enforcement… more
- MyFlorida (Quincy, FL)
- PUBLIC HEALTH SERVICES MANAGER B-SES - 64028011 Date: Oct 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 861353 Agency: Department of Health Working Title: PUBLIC HEALTH SERVICES MANAGER B-SES - 64028011 Pay Plan: SES Position Number: 64028011 Salary: $45,060.11… more
- The County of Los Angeles (Los Angeles, CA)
- …where necessary. Formulates policies and procedures concerning program administration, ensuring compliance with Federal and State Medicare and Medicaid ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply MENTAL… more
- ACHIEVE (Broome County, NY)
- Residence Manager - Broome County Broome County, NY (http://maps.google.com/maps?q=Binghamton+NY+USA+13905) Apply Description Duties & Responsibilities:The Program ... Manager is responsible for overall functioning and oversight of...and administrative reviews of Habilitation Plans, monthly notes and Medicaid billing to ensure that the plans meet agency… more
- The County of Los Angeles (Los Angeles, CA)
- …where necessary. + Formulates policies and procedures concerning administration, ensuring compliance with Federal and State Medicare and Medicaid regulations ... MENTAL HEALTH PROGRAM MANAGER I/EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4658522) Apply MENTAL… more
- Covenant Health Inc. (Lenoir City, TN)
- Overview Senior Risk Manager Full Time,80 Hours Per Pay Period, Day Shifts Fort Loudoun Medical Center is equipped with a team of more than 200 doctors in more than ... care to every patient, every time. Position Summary: The senior risk manager is responsible for the facility's risk management activities, which include, but… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Level II (in addition to Level I Accountabilities) + Performs more complex investigations with less direct supervision. Performs compliance and/or governance on ... to Level II Accountabilities) + Manages the highest level of complex investigations , compliance and regulatory issues and exercises decision-making in project… more
- BrightSpring Health Services (San Antonio, TX)
- …and compliance to service site/company policy to maintain licensure, Medicaid , or other funding + Monitors staffing schedules, overtime, staff vacancy rates ... life we encourage you to apply today! Responsibilities + The Day Services Manager is responsible for the operation of day services, including personnel, operational… more
- AdventHealth (Wesley Chapel, FL)
- …prevention of patient care-related grievances per established patient grievance protocol in compliance with the Centers for Medicare and Medicaid Services (CMS). ... west and central Pasco. **The role you'll contribute:** As the RN Clinical Risk Manager , operating under the direction of the Director, assists in the planning and… more
- University of Washington (Seattle, WA)
- …Counseling Services Team (IECS)** has an outstanding opportunity for a **Financial Counselor Manager ** . **WORK SCHEDULE** + 100% FTE (40 hours per week) + Mondays ... training and development initiatives. + Enforce productivity, quality, and compliance standards; develop and implement departmental procedures and improvements. +… more
- Johns Hopkins University (Baltimore, MD)
- **General Summary** We are seeking an **_Internal Audit Manager ,_** who demonstrates subject matter expertise in operational internal auditing and the healthcare ... audit tools and techniques. + Conduct specialized audits, projects or investigations requested by Institutional leadership. + Represent department on assigned… more
- Centene Corporation (Indianapolis, IN)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Manage compliance with all Federal and State Laws and Regulations related to ... federal requirements and monitoring trends and schemes. + Dedicated to our Indiana Medicaid product lines. + Safeguard against the potential for fraud, waste and… more
