- Cambia Health Solutions, Inc (Portland, OR)
- Compliance Analyst II or IIIWork Remotely from Oregon, Washington, Idaho or UtahPrimary Job PurposeAs a member of the Compliance team, the Compliance ... Special projects may be assigned as needed.We are seeking an individual with Medicare compliance experience to assist in prevention, detection, and remediation… more
- Cambia Health Solutions, Inc (Portland, OR)
- General Compliance Analyst II/IIIWork Remotely from Oregon, Washington, Idaho or UtahPrimary Job PurposeAs a member of the Compliance team, the Compliance ... Analyst II/III is responsible to deliver an effective compliance program. They design, implement, deliver, measure and refine activities and controls to… more
- George Washington University (Washington, DC)
- …GW MFA/University policies and procedures. Provides direct oversight of: Sr. Financial Analyst or budget preparation, performance of Medicare Coverage Analysis ... rules and regulations pertaining to privacy and clinical research billing compliance , FDA regulated drug and device trials, and/or clinical research sponsored… more
- CVS Health (Phoenix, AZ)
- …organization. + In partnership with and under the direction of the health plan Medicare Compliance Officer and other team members, this position will help ... elements and compliance department responsibilities required under the Medicare Compliance Program, which include but are not limited to meeting attendance,… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** ... **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more
- Commonwealth Care Alliance (Boston, MA)
- …preferred. + 5 or more years direct work experience in regulatory affairs and/or compliance in Medicare or Medicaid required. + Health care industry experience ... to Us:** The primary focus areas of this position is managing compliance issues and regulatory responses including Corrective Action Plan (CAP) monitoring,… more
- The Cigna Group (Houston, TX)
- **The Provider Performance Lead Analyst is a key member of the market that assists in the growth and development of the provider network. The Lead Analyst is the ... the individual that represents Cigna MA.** The Provider Performance Lead Analyst 's responsibilities include: + Supporting the development, management and oversight… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, the Medicare Advantage Premium Billing Analyst plays a vital role in ensuring accurate and ... of invoices. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail...interpret State (CA DHS) and CMS files to ensure compliance with regulations + Utilize knowledge of finance, accounting,… more
- State of Indiana (Indianapolis, IN)
- Medicare Claims Analyst Date Posted: May 8, 2024 Requisition ID: 443202 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with the ... is fully engaged with this mission. Role Overview: The Medicare Claims Analyst will serve as the...ensure it meets federal and state policies and grants compliance . + Develop and supervise training of employees and… more
- Cleveland Clinic (Cleveland, OH)
- …organizations in the world. Our department is looking to add a Senior Financial Analyst to their dedicated team of caregivers. In this role, you will provide ... should have the following experience: * Prepares and files Medicare and Medicaid cost reports on a timely and...changes and proposes cost report handling. * Assists on compliance issues as required * Assists with third party… more
- UCLA Health (Los Angeles, CA)
- …this and more at UCLA Health. As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running processes/jobs ... required * Five or more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5 years of experience with Encounter… more
- The Cigna Group (Bloomfield, CT)
- …medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts. **Schedule:** 8:30 ... medical necessity and appropriateness of setting according to established policies and compliance guidelines. *Uses an established set of criteria to evaluates and… more
- Universal Health Services (Reno, NV)
- …the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Compliance Analyst provides support to the organization to execute ... key initiatives for the effectiveness of the Compliance Program for health plan products, including ...third-party administration, and other commercial health plan products. The Compliance Analyst captures and analyzes data used… more
- Penn Medicine (Philadelphia, PA)
- …Department - Office of Billing Compliance Location - 3600 Market St Hours - Remote Compliance Analyst I The Compliance Analyst (CA) I is responsible ... the changes in the CPT coding, CMS regulations, local Medicare carrier (Novitas) in order to provide the most...Novitas website + Familiarity with Penn Chart (Epic EMR) Compliance Analyst II The Compliance … more
- Providence (WA)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... to optimize performance + Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements + Collaborating with… more
- Dartmouth Health (Lebanon, NH)
- … regulations related to the First-Tier, Downstream and Related Entity (“FDR”) Medicare Compliance Program Guidance in collaboration with DH Corporate ... Overview The ACO Compliance Program Analyst (the “Program ...Medicare Advantage directed First-Tier Downstream Related Entity (FDR) compliance program. Administration activities will include, but are not… more
- Robert Half Management Resources (Dallas, TX)
- … Medicare & Medicaid Services (CMS) * Understanding of Medicare and Medicare Risk Adjustment * Experience in compliance functions, compliance metrics, ... are offering a contract to hire employment opportunity for a Sr. Medical Claims Analyst based in Dallas, Texas.. This role is within the healthcare industry and… more
- Randstad US (Phoenix, AZ)
- legal compliance associate analyst . + phoenix , arizona (remote) + posted april 30, 2024 **job details** summary + $27 - $28.78 per hour + temporary + bachelor ... business and financial operations occupations + referenceAB_4525099 job details The Medicare Marketing Oversight Specialist is a compliance -minded individual who… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Sr. Contract Compliance Analyst III Date: Apr 17, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 54798 **Who ... to key internal and external stakeholders. In addition, the Sr. Contract Compliance Analyst will participate in identifying and recommending contracting strategy… more
- UCLA Health (Los Angeles, CA)
- …member of the Medicare Advantage Compliance team, the Senior Compliance Data Analyst plays a crucial role in autonomously crafting detailed requirement ... both functional and non-functional requirements align with the Senior Compliance Data Analyst 's vision and are effectively...* Minimum of five (5) years' experience in a Medicare or Managed Care Compliance environment, required.… more
