- Novo Nordisk Inc. (WA)
- …as well as other Market Access & Public Affairs teams, Medical, Legal, Compliance , Communications and other key stakeholders locally and globally. External ... and globally. Relationships Reports to the Market Access and Public Affairs Senior Director, Policy. Other internal relationships include a dotted line with… more
- Molina Healthcare (Albany, NY)
- …or related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with ... CTM portal, SLA tracking, and program audits. * Deep knowledge of Medicare regulations affecting complaints, grievances, and member communications . * Exposure… more
- Humana (Lansing, MI)
- … supporting both the business and public relations strategies. + Develops corporate communications to be shared with senior leadership. + Supports trend ... for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **Required Experience:** ** Communications and Training** **Job Summary** Provider Network Administration is responsible for the accurate and ... that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations.… more
- Centene Corporation (Austin, TX)
- …and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads ... organization for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and… more
- Centene Corporation (Tallahassee, FL)
- …in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the auditing and monitoring ... with business areas to ensure effective prevention, detection, and correction of compliance issues. Facilitates and leads external audits related to Risk Adjustment… more
- Sutter Health (Palo Alto, CA)
- …collateral, talking points, impact reports, web pages, magazines, and videos. The Senior Director ensures that all communications are narratively and visually ... Health! **Organization:** PAMF-Palo Alto Medical Foundation PAD **Position Overview:** The Senior Director plays an essential role in Sutter Health's ability to… more
- Tucson Electric Power (Tucson, AZ)
- …, including: o Employee Health & Welfare: Plan design, modification, communications , employee education, compliance , recordkeeping, reporting, and disclosure. o ... defined contribution** **retirement plans** , including plan design, modification, communications , employee education, compliance , recordkeeping, reporting, and… more
- CenterWell (Phoenix, AZ)
- …other providers to form a narrow network of quality service focused on senior population health + Responsible for medical interpretation, reviews, and decisions as ... the organization in community and marketing events. + Develop and maintain compliance with the departmental and physician budgets. + Assess, develop and recommend… more
- Martin's Point Health Care (Portland, ME)
- …but not limited to provider reimbursement, claims processing, benefit adjudication, and compliance + Support senior management (Chiefs and VPs) with special ... and support to the company, including responsibility for the actuarial support of Medicare product bids, US Family Health Plan (USFHP) rate negotiations with the… more
- CVS Health (Woonsocket, RI)
- …through oversight of, and engagement with; Ariba, Contracts, Third Party Risk, Medicare Compliance , AP, Sourcing, and internal/external Auditors. Lead annual ... each and every day. We are seeking an experienced and enthusiastic Print Production Senior Manager to join our team. The Print Production Senior Manager is… more
- ChenMed (Miami, FL)
- …contracts and instruments. + Ability to independently manage complex regulatory compliance matters which pose significant risk to the organization. + Regularly ... deals with members of senior management on matters within his/her area of legal...Law, Anti-Kickback Law and other federal and state healthcare compliance matters, and drafting complex agreements and other legal… more
- Toyota (Plano, TX)
- …Toyota Legal One (TL1), is looking for a passionate and highly motivated ** Senior Manager, Legal Operations.** This role is responsible for the strategic planning ... eDiscovery and litigation support, outside counsel and vendor management, legal compliance , General Counsel and Leadership Team support, knowledge management, and… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Senior Quality Improvement Professional supports Quality Improvement functions for the Ohio Medicaid ... plan. The Senior Quality Improvement Professional works assignments and projects that...procedures, and systems + Experience in member/provider education and communications **Workstyle: Remote Work at Home** **Schedule/Hours:** + Monday… more
- The Cigna Group (Bloomfield, CT)
- …federal provider laws, responding to regulatory inquiries, and reviewing external communications . This position requires a general working knowledge of laws ... enterprises, corporate practice of medicine, fee splitting, compensation, licensing, Medicare enrollment, anti-kickback/FWA, privacy, friendly PC model, scopes of… more
- University of Virginia (Charlottesville, VA)
- …(Flex -Actual) 9.37, Work FTE Var (Flex -Actual) YTD 10.17. Access Associate Senior Worked FTE Variance (Flex-Actual) variable job role MC_103045 1.09. Units of ... implementation of work area procedures to ensure efficient operations and compliance with regulatory standards. + Constantly and consistently evaluates processes,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …requirements as they apply to business continuity activities and ensure full compliance with these requirements in addition to internal organizational policies and ... with Information Solutions Disaster Recovery, Corporate (Physical) Security, Corporate Communications , HR, and other key internal stakeholders + Participate in… more
- Banc of California (Santa Ana, CA)
- …with Benefits Team on various wellness program projects, including coordinating communications campaigns, employee mailings and working with outside vendors as ... knowledge of all pertinent federal and state regulations, filing and compliance requirements, both adopted and pending, affecting employee benefits programs,… more
- CVS Health (Atlanta, GA)
- …impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... completing required actions with a high level of detail to ensure Compliance and Regulatory Standards are met. + Effectively supports members during enrollment… more
- World Insurance Associates, LLC. (Philadelphia, PA)
- …assigned SME resources, track open items and deliver notes to client (includes compliance needs including 5500 filing, Medicare Part D Disclosures, Reporting, ... implementation project plans + Oversee development and preparation of OE/Benefit communications materials and BenAdmin Technology, where applicable + Develop and… more
