- Trinity Health (Silver Spring, MD)
- …and committees to meet established goals for physician participation and compliance with expectations. Designs, implements, and directs system wide programs for ... issues, discharge planning (DP) advise and quality issues. Functions as a consultant and resource to other Physician Advisors and primary (attending) physicians. 2.… more
- City of New York (New York, NY)
- …of Homeless Services (DHS). DSS-AO maintains the operation of the Office of Audit and Quality Assurance (OAQA), Office of Compliance and Support (OCS), ... agendas in OQA&FI geared towards monitoring the performance and compliance of Cash Assistance, SNAP, and Medicaid ...expected to be available whenever required to address any audit , program compliance , fiscal integrity, quality assurance… more
- Cardinal Health (Oklahoma City, OK)
- …+ Audit government fee schedules and maintain pricing for Managed Medicaid contracts. + Audit RGH and TriZetto to ensure accurate pricing ... pertain to services provided by the Company. This includes supporting and demonstrating compliance with the Company's Compliance and HIPAA Plans. + Promptly… more
- OhioHealth (Columbus, OH)
- …mechanisms & methodologies, health plan benefits designs (commercial, Medicaid & Medicare), and referral/authorization processes. + Understanding of ... + Understanding NCQA Accreditation elements, policies and procedures for successful audit , + Computer skill, expertise and experience with MicroSoft Word, Excel,… more
- Delta Dental of Iowa (Johnston, IA)
- …Compliance Program. In this role, you will help ensure regulatory compliance by maintaining audit -ready documentation, tracking issues, translating complex ... a mission-driven environment. This hybrid role collaborates with the Compliance & Legal Consultant and reports to...Work Plan and upholds organized, verifiable records to support audit readiness. + Analyze and interpret federal and state… more
- NHS Management, LLC (Birmingham, AL)
- …Specialist Consultants, Internal Auditor, or any other corporate or regulatory compliance consultant . Communicates progress toward goals and ongoing obstacles ... Specialist Consultants, Internal Auditor, or any other corporate or regulatory compliance consultant . Communicates progress toward goals and ongoing obstacles… more
- Robert Half Management Resources (Burbank, CA)
- …Overview: Our client, a leading healthcare organization, is seeking an experienced Medicaid Enrollment & Eligibility Consultant for a fully remote, ... will play a key part in evaluating and optimizing Medicaid enrollment and eligibility operations, ensuring compliance ,...(SOPs), job aids, and training materials. + Assist in audit preparation, compliance reviews, and regulatory reporting… more
- Prime Therapeutics (Oklahoma City, OK)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate...guidance. + Coordinates with external auditors for yearly SOC-1 audit . + Works directly with Director to fulfill OIG… more
- Houston Methodist (Houston, TX)
- …regulatory program requirements and activities. The position serves as a consultant , resource, mentor, and educator for regulatory and accreditation programs; works ... across the system to assess, measure, and report compliance with standards; and develops, implements and evaluates strategies...surveys across the HM system using ISO 9001 process audit tools and techniques to evaluate the effectiveness of… more
- Trinity Health (Silver Spring, MD)
- …and committees to meet established goals for physician participation and compliance with expectations. Designs, implements, and directs system wide programs for ... issues, discharge planning (DP) advise and quality issues. Functions as a consultant and resource to other Physician Advisors and primary (attending) physicians.… more
- CenterWell (Savannah, GA)
- …to individual clinicians about patient terminations, in + collaboration with Compliance + Supporting clinicians with schedule templates, coverage, daily issues + ... and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality care and...and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to five… more
- MyFlorida (Gainesville, FL)
- …for the coordination, development, and implementation of nursing procedures in compliance with professional nursing standards, the Joint Commission on Accreditation ... of Hospitals, Agency for Health Care Administration, and the Centers for Medicaid and Medicare Services. + Performs periodic quality care reviews and develops,… more
