- CVS Health (Richmond, VA)
- …state Board of Pharmacy (BOP) websites + Prior experience working with FWA, regulatory , or auditing programs + 1-3 years Medicare managed care experience ... help to support various Scorable Action Items (SAI) programs in the Medicare population, including Fraud, Waste, and Abuse (FWA), Formulary Education, Therapeutic… more
- Trinity Health (Sioux City, IA)
- …Days **Position Purpose** The purpose of the Accreditation and Risk Management Specialist is to facilitate regulatory and risk management activities, in ... compliance, enhances patient safety, and minimizes liability exposure. The specialist role is a lead resource in the Centers...role is a lead resource in the Centers for Medicare and Medicaid Services (CMS) regulatory requirements… more
- Fallon Health (Worcester, MA)
- …submits appropriate long -term care change forms as needed. * Completes Medicare , Medicaid and private pay reconciliations in conjunction with FCHP staff. * ... 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
- CVS Health (Topeka, KS)
- …make health care more personal, convenient and affordable. Position Summary The Care Manager Specialist is a member of the Care Team. The Care Manager Specialist ... are usually stratified as low risk. The Care Manager Specialist will work in conjunction with the Nurse Care...Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Hospital and Ambulatory ... (HAPG), Division of Practitioner Services (DPS). As a Supervisory Health Insurance Specialist , GS-0107-15, you will serve as Director, an authority on the scope… more
- Sea Mar Community Health Centers (Federal Way, WA)
- …a mandatory COVID-19 and flu vaccine organization Credentialing & Provider Enrollment Specialist - Posting #26191 Hourly Rate: $25.00 - $29.00 Annual Salary: $52,000 ... Mar Community Health Centers seeks an experienced Credentialing & Provider Enrollment Specialist . This is a Full-time position (Monday-Friday) 8:00 am to 5:00 pm.… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **Job Title: Clinical Pharmacy Specialist - Drug Information** **This position is located in Lancaster, PA.** **Schedule is ... discussed further during on-site interview.** **The Drug Information Clinical Pharmacy Specialist is part-time position (0.5 FTE) responsible for supporting the… more
- Bluestone Physician Services (Stillwater, MN)
- …Bluestone also achieved Top Workplace USA! Position Overview : The Medical Coding Specialist role is responsible for ensuring that patients are billed correctly for ... clinicians with ongoing guidance on coding best practices based on established regulatory standards as needed. Candidates for this remote role must be located… more
- Help at Home (Chicago, IL)
- …Responsibilities:_** + Effectively address and resolve intermediary licensing and certification ( Medicare and Medicaid) issues while adhering to regulatory norms ... a good fit for you._ **_Job Summary:_** The Senior Licensing Specialist is responsible for independently handling moderately complex problems, specifically… more
- Honor Community Health (Pontiac, MI)
- …Under the supervision of the Project Director for the CCBHC the CCBHC Peer Support Specialist t he Peer Support Specialist serves as a member of the ... services for individuals experiencing serious mental illness. The Peer Support Specialist works closely with individuals with mental illness and substance use… more
- STERIS (Sharon, PA)
- Quality Specialist Req ID: 39005 Job Category: Quality Sharon, PA, US, 16146 Description: At STERIS, we help our Customers create a healthier and safer world by ... product and service solutions around the globe. Position Summary The Quality Specialist is responsible for assisting in administration of the quality functions at… more
- Adams County Government (Westminster, CO)
- Medical Billing and Coding Specialist -165320 Print (https://www.governmentjobs.com/careers/adams/jobs/newprint/4469087) Apply Medical Billing and Coding ... Specialist -165320 Salary $52,886.08 - $74,041.76 Annually Location Westminster, CO...guidelines, grant deliverable requirements, TITLE X requirements and any regulatory guidelines or requirements that may apply. + Audits… more
- Lancaster General Health (Lancaster, PA)
- …or heath information management team with in the established time frames. Compliance/ Regulatory + Completes documentation for compliance and regulatory needs ... of orders + Retains knowledge and abides by all regulatory requirements pertaining to duties of position and overall...+ A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II (RN or LCSW) Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: ... purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management and oversight...Identify any gaps in the Care Plan services or regulatory compliance and provide coaching and feedback to the… more
- Sharp HealthCare (San Diego, CA)
- …skilled nursing facility placement or home care. Ensures compliance with all applicable regulatory and health plan guidelines for issuance of notice letters ie ... Medicare notice of non-coverage, Commercial notice of non-coverage or...patient financial services for financial screening on patients requiring long term custodial placement. Accurately documents patient's clinical condition… more
- BrightSpring Health Services (Honolulu, HI)
- …pharmacywhere you can focus on fulfilling the pharmaceutical needs of our long -term care and senior living clients. We offer a non-retail pharmacyenvironment. Our ... service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long -term acute care hospitals, and other specialized care centers nationwide. If… more
- Healthfirst (New York, NY)
- …certifications with accredited associations or organizations. + Experience with Medicare Compliance & Regulatory Responsibilities, and Marketing Practices. ... Summary The Learning Delivery Specialist will act as an ambassador in fostering...Healthfirst service area (Manhattan, Brooklyn, Queens, Bronx, Staten Island, Long Island, Westchester, Mid-Hudson). Preferred Qualifications + Bachelor's degree… more
- CVS Health (Columbus, OH)
- …impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... proactive plan of care to address identified issues to enhance the short and long -term outcomes as well as opportunities to enhance a member's overall wellness. +… more
- CVS Health (Raleigh, NC)
- …impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Required… more
- CVS Health (Jackson, MS)
- …impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Required… more