- Commonwealth Care Alliance (Boston, MA)
- …to learn new systems and databases that CCA implements. - Working knowledge of Medicare and Medicaid ( MassHealth ) - Demonstrated skills in Excel and PowerPoint - ... of Medicare , Medicaid, duals program, and health plan operations, including regulatory and compliance requirements. - Demonstrated knowledge of DMH system… more
- Commonwealth Care Alliance (Boston, MA)
- …health, and/or social needs. + Strong understanding of ** Medicare , Medicaid ( MassHealth ), and dual-eligible program operations** , including regulatory and ... in partnership with internal and external stakeholders. + Ensure compliance with all regulatory and contractual requirements...have):** + 5+ years + Experience with Medicaid and Medicare products and programs + Experience or knowledge of… more
- Commonwealth Care Alliance (Boston, MA)
- …to learn new systems and databases that CCA implements. - Working knowledge of Medicare and Medicaid ( MassHealth ) - Familiarity with and full support of ... of Medicare , Medicaid, duals program, and health plan operations, including regulatory and compliance requirements. - Demonstrated knowledge of DMH system… more
- Commonwealth Care Alliance (Boston, MA)
- …waste and abuse; suspected privacy and/or security incidents; or any compliance concerns identified + Ensures confidentiality of patient and company proprietary ... Medicaid Enrollment + If works in MA role requires MassHealth Enrollment + Candidate will be required to pass...to manage competing priorities + Familiarity with MA nursing regulatory scope and guidelines **Desired Knowledge, Skills & Abilities:**… more
- Commonwealth Care Alliance (Boston, MA)
- …does not have direct reports. Essential Duties & Responsibilities: Regulatory Compliance & Monitoring * Monitor CMS and MassHealth regulations, bulletins, ... compliance with state and federal healthcare regulations, particularly MassHealth (Massachusetts Medicaid) and CMS Medicare requirements. This role… more
- Fallon Health (Foxborough, MA)
- …for people age 65 and older, who live in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more
- Fallon Health (Worcester, MA)
- …of Coverage, and in compliance with applicable NCQA standards, CMS, MassHealth and other state or federal regulatory requirements. Strict adherence to ... representative. + Submit additional documentation if requested during or after the hearing. ** Regulatory Compliance ** + Ensure all appeal activities comply with … more
- Dana-Farber Cancer Institute (Brookline, MA)
- …attention to detail, sound judgment, discretion with PHI, and commitment to regulatory compliance and internal control practices. + Proficiency with Microsoft ... Revenue Integrity/Charge Capture, Health Information Services and Access/Registration. + Ensure regulatory and policy compliance for government programs, eg, CMS… more
- Fallon Health (Worcester, MA)
- …FH's compliance with CMS regulations, NCQA standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
