- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual ... to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and implement new CMS requirements + Monitor,… more
- CVS Health (Moon Township, PA)
- …or concerns. Maintains enrollment data in eligibility systems to ensure compliance with CMS guidance requirements. Required Qualifications + Meet Monthly Metrics ... Supervisor + Keep a positive attitude as changes occur Preferred Qualifications + Medicare industry experience. + Familiarity with Medicare Enrollment systems +… more
- CVS Health (Moon Township, PA)
- …or concerns. Maintains enrollment data in eligibility systems to ensure compliance with CMS guidance requirements. Required Qualifications + Meet Monthly Metrics ... Supervisor + Keep a positive attitude as changes occur Preferred Qualifications + Medicare industry experience. + Familiarity with Medicare Enrollment systems +… more
- Sedgwick (Columbus, OH)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Medicare Compliance Nurse Team Lead **PRIMARY PURPOSE** **:** To supervise ... Medicare Compliance Nurses/ Medicare ...an accredited college or university preferred. RN licensure and Medicare Set-Aside Consultant Certified (MSCC) certification required.… more
- CareOregon (Portland, OR)
- …on strategies to impact rates. + Oversee and coordinate external actuarial consultant 's work preparing the annual Medicare Advantage bid; advise internal ... or Wisconsin. Job Title Actuarial Services Manager - Medicaid and Medicare Exemption Status Exempt Department Finance Manager Title Director, Actuarial Services… more
- CVS Health (Hartford, CT)
- …clinical records to apply appropriate clinical criteria and policies in compliance with regulatory and accreditation requirements for members and providers. ... regulatory requirements to support appeals review. + Ensures appeal process compliance with regulatory and accreditation standards. + Counsels with members,… more
- WellSense (Boston, MA)
- Provider Relations Consultant (Boston/Northeast MA) - $5000 sign on bonus! WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25...no matter their circumstances. As a WellSense Provider Relations Consultant , you'll act as the primary liaison between WellSense's… more
- CVS Health (Trenton, NJ)
- …is a Scrum Team role that will be a member of the Medicare / Medicaid Enrollment Configuration team tasked with developing purposebuilt capabilities for our ... a member of the team to deliver purpose built configuration for the Medicare Enrollment Operations Team on the NextGeneration Platform.* Independently designs and /… more
- AbbVie (Minneapolis, MN)
- …will be hired at a level commensurate with experience. The Account Consultant position manages sales processes for AbbVie's therapeutic products in accordance with ... the franchise goals. Complies with required reports, requests, and promotional compliance and effectively manages AbbVie field Assets Qualifications *Achieve and… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Compensation Consultant (Remote) **Cost Center:** 101651125 Human Resources **Scheduled Weekly Hours:** 40 ... Mon-Fri; day shifts (United States of America) **Job Description:** The Compensation Consultant works as a key resource within the Human Resources department… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Elderly Waiver Policy Consultant ** **Job Class: Human Services Program Consultant ** **Agency: Human Services Department** + **Who May Apply** : ... workforce dedicated to creating a better Minnesota. The Elderly Waiver Policy Consultant will manage and coordinate the Elderly Waiver (EW), Consumer Directed… more
- Elevance Health (Houston, TX)
- …check, or ask you for payment as part of consideration for employment. **Strategic Vendor Consultant ** + Job Family: PUR > Vendor Relations + Type: Full time + Date ... Grand Prairie, TX Elevance Health office locations.**_ The **Strategic Vendor Consultant ** will be responsible for managing relationships with vendors, stakeholders,… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The goal of the Clinical Documentation Specialist- Consultant is to educate leaders, physicians, advanced practice providers (APP), and other ... education plans, interventions, and training. + Acts as an education leader, consultant , and mentor to leaders, physicians, APP's, and other staff about… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- HEALTH SERVICES CONSULTANT Augusta , Maine , United States | Nursing | Full-time Apply by: April 29, 2024 Apply with Linkedin Apply Department of Health and Human ... facilities and adult family care homes. Core Responsibilities: As a Health Services Consultant working in the Case Mix and Classification Unit you will conduct… more
- Elevance Health (Tampa, FL)
- …or ask you for payment as part of consideration for employment. **Group Underwriting Consultant Sr.** + Job Family: UND > Group Underwriting + Type: Full time + ... work and in office days 1-2 times per week. The **Group Underwriting Consultant Sr.** is responsible for determining acceptability of insurance risks and appropriate… more
- ABCM Corp (Hampton, IA)
- Corporate Nurse Consultant - RN ABCM Corporation - Corporate Office (https://abcmcorporation.easyapply.co) Hampton, IA $80000.00 to $95000.00 per year Summary Under ... (CEO) / Chief Operating Officer (COO): + Monitors corporate compliance and the quality of care, services, and life...and reliable transportation required + Per the Centers for Medicare and Medicaid Services (CMS), COVID-19 vaccination is required,… more
- Public Consulting Group (Columbus, OH)
- …and systems; increase program revenue; cut costs; and improve regulatory compliance with state and federal regulations. To learn more, visit ... and/or career ladder innovation. + Experience partnering with the Centers for Medicare and Medicaid Services (CMS) for the approval of Medicaid benefits. +… more
- AbbVie (Birmingham, AL)
- …+ Comply with all company policies, required reports, requests and promotional compliance and effectively manages Abbvie field assets. + Understand and utilize ... Valid Driver's License + Experience selling in a "buy and bill" Medicare part B/Medical benefit environment and understanding of reimbursement challenges and… more
- Universal Health Services (Reno, NV)
- …for overseeing the organization's operational areas. This position serves as an internal consultant to management and staff regarding compliance with Federal and ... State and Federal laws, regulations, policies and practices for the administration of Medicare Advantage, Prescription Drug Plan, and compliance programs in a… 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