- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …people + This role reports to this job: Director , Medicare Advantage Compliance & Medicare Compliance Officer + Necessary Contacts: In order to ... manages administrative elements of the Companies' (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program, including development and maintenance of… more
- Somatus (Mclean, VA)
- Overview The Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment Programs to ... optimize the programs' clinical benefit, financial accuracy and ensure program compliance with governing bodies' regulations, including the Center for Medicare … more
- CVS Health (Hartford, CT)
- …as: Marketing, Compliance , Regional Sales Directors, National Sales Directors , Medicare VPs, Stars team, Medicaid team and various other departments as needed. ... convenient and affordable. Position Summary Works closely with the Executive Director , National SNP Sales Strategy, in the creation, refinement and delivery… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …colors to blue. What we need: As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the ... to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and implement new CMS requirements + Monitor,… more
- CareOregon (Portland, OR)
- …and Medicare Exemption Status Exempt Department Finance Manager Title Director , Actuarial Services Direct Reports Actuarial Staff Requisition # 24102 Pay and ... position is responsible for managing actuarial analysis related to Medicaid and Medicare Advantage lines of business with a focus on supporting strategic decision… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …of, Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements : The physical requirements ... Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island,...additional marketing locations while adhering to company regulatory guidelines. Compliance + Requires continues education to stay abreast on… more
- CareOregon (Portland, OR)
- … Medicare Administration Manager Title Chief Financial Officer Direct Reports Director , Medicare Requisition # 24180 Pay and Benefits Estimated hiring ... days a week. Job Summary The Vice President of Medicare is responsible for strategy and execution of the...Adhere to the organization's policies, procedures and other relevant compliance needs. + Perform other duties as needed. Experience… more
- CVS Health (Santa Ana, CA)
- …business. CVS Health/Aetna is working to transform the way California Medicare beneficiaries experience health care - improving quality, emphasizing whole-person ... Manager to support the growth of our industry leading Medicare business. This is a highly collaborative role in...the United States and will report to the Sales Director for Southern California. This is a career position… more
- CVS Health (Buffalo Grove, IL)
- …more personal, convenient and affordable. Position Summary The Sr. Clinical Pharmacist, Medicare - Medical Affairs leads within the Medical Affairs team and external ... across the organization to support customer needs. The Sr. Clinical Pharmacist, Medicare - Medical Affairs is responsible for supporting the creation and maintenance… more
- CVS Health (Lansing, MI)
- …is hiring a local Broker Manager to support the growth of our industry leading Medicare business. This is a highly collaborative role that will report to the Sales ... of market strategy impacting the recruitment, onboarding, engagement, production, and compliance adherence of assigned independent broker base. - Travel expectations… more
- The Cigna Group (Birmingham, AL)
- …member of the Provider Contracting Team and reports to the Provider Contracting Director . This role assists in developing the strategic direction and management of ... to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance , Sales and Marketing and Service. + Manages strategic positioning… more
- CareFirst (Baltimore, MD)
- …identified during risk and control assessments to the IRM Director and the Medicare and Medicaid Compliance Officer. + The intent of this list of primary ... (GRC) Program + Provide support to the Medicaid Integrated Compliance team and the Medicare and Medicaid Compliance Officer to ensure compliance… more
- NASCO (Columbus, OH)
- **Overview** Under general direction, the Executive Director , Compliance will lead and provide oversight and management of Compliance and Privacy functions ... and serve as the company's Compliance and Privacy Official. Responsible for overseeing the company's... Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director , ADA Compliance Officer serves as the primary subject matter expert and central point of contact for all ... of 1-2 Analysts **What You'll Be Doing:** + Maintain ADA Compliance and Medicare /Medicaid expertise regarding applicable state/federal law regulations… more
- Bozeman Health (Bozeman, MT)
- Position Summary: The Bozeman Health Board of Directors has designated the System Director of Compliance & Privacy to serve as its Compliance Officer. This ... role in ensuring that the organization operates in full compliance with health care laws and regulations. The ...accuracy and validity of coding and billing submitted to Medicare , Medicaid, other federal and state health programs and… more
- Brockton Hospital (Brockton, MA)
- …a difference in the lives and health of our patients. Position Summary: The Assistant Director , Corporate Compliance (Assistant Director ) is a member of the ... Compliance Department and reports to the Chief Compliance Officer. This position is responsible for assisting the...audit methodology, with a focus on government payers including Medicare and Medicaid. + Applies knowledge of Medicare… more
- CareOregon (Portland, OR)
- …Minimum 8 years' experience in related work, including 4 years' experience in Medicaid/ Medicare compliance and quality assurance experience + Minimum 4 years' ... Job Title Director , Compliance and Quality Oversight Exemption...as they relate to the administration of OHP and Medicare + the principles and practices of coordinated care… more
- HCA Healthcare (Riverside, CA)
- …is hired below midpoint of the range. **Introduction** We are seeking a(an) Director of Regulatory Compliance with Riverside Community Hospital to promote growth ... benefits may vary by location._** We are seeking a(an) Director of Regulatory Compliance for our team...role provides oversight for matters including the Centers for Medicare and Medicaid Services (CMS), The Joint Commission (TJC),… more
- Weill Cornell Medical College (New York, NY)
- Title: Executive Director & Clinical Compliance Officer Location: Midtown Org Unit: Compliance and Privacy Office Work Days: Monday-Friday Exemption Status: ... Oversees the effectiveness, operation, administration, and management of the Clinical Compliance and Privacy programs. Provides strategic direction and oversight for… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more