- Cambia Health Solutions, Inc (Portland, OR)
- …or equivalent related experience, with experience in a health care or Medicare -regulated environment preferred. Compliance Specialist III would have at ... Special projects may be assigned as needed.We are seeking an individual with Medicare compliance experience to assist in prevention, detection, and remediation… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of improving the health of our communities. About the Role:Job SummaryThe Research Regulatory Specialist performs a wide range of tasks essential to the ... submission, approval, and maintenance of required regulatory documents for conducting clinical research in compliance with the Federal Food and Drug… more
- Option Care Health (Bannockburn, IL)
- … compliance with privacy rules and requirements as well as other regulatory and legal requirements.Identifies potential areas of compliance and privacy risk ... of Medicare , Medicaid, and Managed Care reimbursement guidelines.Certification in Compliance as recognized by the Society of Corporate Compliance and… more
- Cambia Health Solutions, Inc (Portland, OR)
- Benefit Specialist II or III, DOERemote opportunity for residents of Oregon, Washington, Idaho and Utah Primary Job PurposeThe Benefit Development Specialist II ... cross-functional activities that impact department operations (ie governmental and regulatory changes). Analyzes interdepartmental procedures and their impact on… more
- ProKatchers (Bowling Green, NY)
- …function of the Clinical Quality Reviewer is to assess and audit medical charts for compliance with a focus on HEDIS, QARR, Medicare Advantage Star measures and ... offices to ensure timely completion of duties to meet internal and regulatory standards and requirements. Perform clinical audits via EMR, in-house paper medical… more
- Cambia Health Solutions, Inc (Portland, OR)
- …or equivalent related experience, with experience in a health care or Medicare -regulated environment preferred. Compliance Specialist III would have at ... of the company.Coordinate regulator inquiries, audits, and investigations, managing compliance and regulatory audit and market conduct activities.Responsibility… more
- Houston Methodist (Katy, TX)
- …Fry Rd. Katy, TX 77450** **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with ... Medicare compliance experience is preferred** **Note:...Center for Medicare /Medicaid Services (CMS), other applicable regulatory agencies, and/or Houston Methodist Internal Audit compliance… more
- Health First (Melbourne, FL)
- …new processes that improve overall productivity. * Knowledgeable of all industry and regulatory changes and implications they pose to Medicare beneficiaries. * ... health plan including coordinating sales events and seminars. * Participate in Medicare collateral material development with marketing and compliance teams. *… more
- Aveanna (Houston, TX)
- …Category: Compliance Salary: $90,000 per year Position Details Position Overview The Regulatory Compliance and Coverage Specialist will report to the ... Regulatory Compliance and Quality Review. The Regulatory Compliance and Coverage Specialist ...RN + Thorough knowledge of the home care industry, Medicare and Medicaid coverage requirements, clinical and operations practices,… more
- VHC Health (Arlington, VA)
- Clinical Operations Regulatory Specialist Job Description Purpose & Scope: The position of Clinical Operations Regulatory Specialist provides auditing ... position ensures that the training and auditing are in compliance with the department's standards, regulatory bodies,...Hospital, received a 5-star rating from the Centers for Medicare and Medicaid Services (CMS) and once again named… more
- University of Washington (Seattle, WA)
- …patients in compliance with evolving regulatory requirements. The Billing Compliance & QC Specialist (payroll title: Program Operations Specialist ) ... Trials Office has an outstanding opportunity for a Billing Compliance & QC Specialist to join their...and discretion in the interpretation and application of the Medicare Clinical Trial Policy, and all relevant UW Medicine… more
- Molina Healthcare (Las Vegas, NV)
- …plan and requires experience within that space. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one ... and implementation of **NCQA accreditation surveys** and federal/state QI compliance activities. This position focuses on **Quality Compliance...surveys. + Has a strong focus on MCO Quality regulatory reporting. + Acts as a lead specialist… more
- Molina Healthcare (Las Vegas, NV)
- …and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality ... or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-,… more
- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking a full time Healthcare Compliance Specialist - Organizational Integrity. This remote role requires the incumbent to reside ... coordinating compliance investigations, annual work plan, and monitoring regulatory compliance across PeaceHealth systems. Responsible for identifying,… more
- Molina Healthcare (Milwaukee, WI)
- …_you must reside in_ **_Wisconsin_** _for this position._ **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one ... of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Implements key quality strategies, which may include initiation… more
- Option Care Health (Bannockburn, IL)
- …**Job Description Summary:** Assists with development, implementation and oversight of compliance and privacy program activities. Supports the execution of the ... Annual Compliance & Privacy Work Plan. Supports policy and procedure...with privacy rules and requirements as well as other regulatory and legal requirements. + Identifies potential areas of… more
- AdventHealth (Tavares, FL)
- …goals, objectives, policies and procedures and ensures quality patient care and regulatory compliance . Actively participates in outstanding customer service and ... patient notifications are provided and documented in a timely manner for compliance : Important Medicare Letters (IML), Medicare Outpatient Observation… more
- Signature Healthcare (Louisville, KY)
- …HealthCARE! How you Will make a difference + Ensure that a company-wide regulatory compliance program is ongoing in accordance with company policies, standards ... 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded...all facilities which includes teaching, training, and application of compliance skills necessary to enhance our resident care and… more
- AdventHealth (Durand, WI)
- …are insured and, if so, gathers details (eg, insurer name, plan subscriber)** Performs Medicare compliance review on all applicable Medicare accounts in ... **Consumer Access Specialist - AdventHealth Durand** **All the benefits and...demographics information, and secures** **the required forms to ensure compliance with regulatory policies** Ensures patient accounts… more
- LA Care Health Plan (Los Angeles, CA)
- …in a high quality and timely manner and ensuring compliance with all regulatory guidelines such as Medicaid (Medi-Cal), Medicare , and the Health Exchange, as ... Quality Management Nurse Specialist RN II Job Category: Clinical Department: Quality...process for potential quality of care and service issues, regulatory compliance with CMS, DMHC, DHCS, and… more
