- Eisai, Inc (Philadelphia, PA)
- …provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through ... cognitive impairment due to Alzheimer's disease (AD) or mild AD. The Neurology Account Specialist (NAS) will be part of a diverse team of sales professionals who… more
- Eisai, Inc (Pittsburgh, PA)
- …provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through ... profile, we want to hear from you. The Senior Oncology Sales Specialist is responsible for meeting/exceeding sales goals through promoting Oncology therapeutic… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring ... healthcare people throughout Los Angeles and beyond. **Req ID** : 11981 **Working Title** : Managed Care Compliance Specialist - Managed Care … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …degree. 5 years of Managed Care experience PREFERRED QUALIFICATIONS: The Compliance Specialist is a service oriented individual with a high degree of ... and functioning as an independent, the Compliance Specialist 's primary function is to ensure the Managed Care business unit is meeting compliance… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Managed Care Credentialing Specialist position is responsible for the timely and accurate completion and submission of managed ... and commercial managed care plans and medicare and medicaid. The Managed Care Credentialing Specialist position has consistent interaction with the… more
- AdventHealth (Altamonte Springs, FL)
- …for each position may vary based on geographical location. **Category:** Managed Care **Organization:** AdventHealth Corporate **Schedule:** Full-time **Shift:** ... all existing and new physicians and other billing health care providers in the AHS system are enrolled in... providers in the AHS system are enrolled in compliance with all affiliation and participation requirements, as well… more
- MSC Industrial Supply Co. (Indianapolis, IN)
- …**Work Location :** Indianapolis, IN **BRIEF POSITION SUMMARY:** The Vendor Managed Inventory (VMI) Specialist ensures customer satisfaction through solutions ... MSC customer solutions and sales associates through execution of CARE program. + CARE is defined as...incremental solution growth. + Lead focus of 100% safety compliance for VMIS team + Repair and maintain vending… more
- University of Michigan (Ann Arbor, MI)
- …employer. **Job Detail** **Job Opening ID** 267243 **Working Title** Managed Care Payer/Operations Analyst **Job Title** Admin Specialist Inter Health **Work ... Managed Care Payer/Operations Analyst Apply Now...to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job...care professionals in a hospital, medical group or managed care setting, such as a health ... required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is...by the ECM Provider. Identify any gaps in the Care Plan services or regulatory compliance and… more
- Huron Consulting Group (Van Buren, AR)
- …pressure to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough to ... pressure to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough to… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category:...care professionals in a hospital, medical group or managed care setting, such as a health ... net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills...systems. Knowledge of and ability to comply with HIPAA compliance . Ability to interview, assess and coordinate care… more
- Access Dubuque (Dubuque, IA)
- Healthcare Compliance Specialist **Hillcrest Family Services** 1 Positions ID: 554109068 Posted On 09/24/2025 **Job Overview** **Responsibilities** The ** ... Compliance Specialist ** is responsible for ensuring that... activities, ensuring confidentiality. + Ensure all documentation is managed in accordance with regulatory requirements. + Other duties… more
- Integra Partners (Troy, MI)
- The Medical Policy & Compliance Specialist is responsible for researching, analyzing, and interpreting CMS (Medicare) and state Medicaid guidelines to ensure the ... improvement initiatives across the company. Salary: $110,000/Annually The Medical Policy & Compliance Specialist responsibilities include but are not limited to:… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 07/28/2025 **Requisition Number** PRN42631B **Job Title** Compliance Specialist **Working Title** Compliance Specialist **Career ... this new federal policy + Ensure that aspects of research security and regulatory compliance are defined and managed through the development and review of… more
- Centene Corporation (Jefferson City, MO)
- …regulations preferred + 1+ years experience in State Medicaid or Federal managed care compliance preferred **Licenses/Certifications:** Certified in ... Complies with all policies and standards. **Education/Experience:** + Bachelor's Degree Managed Care /Health Insurance or related field; or equivalent experience… more
- Ventura County (Ventura, CA)
- …the compliance office. Experienced in leading and training staff on Managed Care , Medicaid, Medi-Cal, Medicare, and Commercial Insurance, they ensure ... billing and supervises or conducts training on the specific areas of Managed Care /Medicaid/Medi-Cal/Medicare and/or Commercial Insurance; + Works with the… more
- Molina Healthcare (Naperville, IL)
- …in healthcare with minimum 2 years' experience in health plan quality improvement, managed care or equivalent experience. + Demonstrated solid business writing ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality… more
- CDPHP (Latham, NY)
- …a part of that experience. With minimal direct management oversight, the Compliance Specialist researches, analyzes and processes all corporate regulatory ... from vendors. The analyst is also responsible for Corporate Compliance escalations related to regulatory complaints through vendor survey...with government regulations including but not limited to CMS, Managed Care law, UR law, DOL/ ERISA… more
- Centene Corporation (Raleigh, NC)
- …Complies with all policies and standards. **Education/Experience:** + Bachelor's Degree Managed Care /Health Insurance or related field, or equivalent experience ... business. Responsibilities include intaking and triaging suspected issues of non- compliance , entry of compliance issues into GRC...required + 5+ years experience in Managed Care /Health Insurance or related experience required… more
- Guidehouse (San Antonio, TX)
- …the ongoing understanding of client and company priorities and expectations + Ensure specialist and project compliance as well as adherence to company/client ... standards and communicate issues of non- compliance to Operations Manager + Monitor specialist ...Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term & Long-Term Disability… more
