- Novo Nordisk Inc. (WA)
- …as other Market Access & Public Affairs teams, Medical, Legal, Compliance , Communications and other key stakeholders locally and globally. External relationships ... include select federal agencies that may develop health care policies that...Tax, Trade, Intellectual Property, Supply Chain, Private Health Insurance, Medicare , Medicaid, Reference Pricing, Pricing / Price Increases, Reimbursement,… more
- PruittHealth (Norcross, GA)
- …line agreement objectives. 12.Follows all PruittHealth policies and procedures, state and federal laws and regulations and report violations and potential issues to ... with members of own and other teams to communicate effectively and ensure compliance with cross-team responsibilities. 17.Carries out all duties with a Commitment to… more
- Humana, Inc. (Chester, PA)
- …our caring community and help us put health first Are you passionate about the Medicare population, looking for an opportunity to work in sales with the ability to ... sales community events, as well as, visiting prospects in their homes. Our Medicare Sales Field Agents sell individual health plan products and educate beneficiaries… more
- Trinity Health (Farmington, MI)
- …needed and assigned by the supervisor. Maintains a working knowledge of applicable Federal , State, and local laws and regulations, Trinity Health's Integrity and ... Compliance Program and Code of Conduct, as well as...orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal , state, or local… more
- Alliance Physical Therapy Partners (Emeryville, CA)
- …constructive feedback and coaching and manages staff performance issues proactively. Assures compliance with Federal / Medicare guidelines and company ... act and federal regulations, including but not limited to HIPAA, Medicare , and Medicaid. Assists in development and implementation of clinical policies and… more
- Liberty Health (Wilmington, NC)
- …in a healthcare setting Experience working with regulatory agencies and compliance environment with practical knowledge of Medicare regulations Experience ... industry. Join us! We are currently seeking an experienced: PROGRAM MANAGER - MEDICARE STARS Full Time, Days JOB SUMMARY: Accountable for the success of end-to-end… more
- Optum (Delano, MN)
- …Review, Medicare Requirements processes as well as State and Federal regulations pertaining to Utilization Review and Discharge Planning The salary range ... the patients physician, ED Provider, and community resources Knowledge of all applicable federal and state regulations. Shows working knowledge of managed care and … more
- Optum (Boulder, CO)
- …on a specific medical unit to drive timely discharges and plans of care CMS Compliance : All Medicare and Medicare Advantage patients are required a delivery ... protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free… more
- Conifer Health Solutions (Federal Way, WA)
- …Travel may be required to meet the needs of the facilities Advanced knowledge of Medicare Part A and familiar with Medicare Part B Intermediate knowledge of ... skills Effective written and verbal communication skills Knowledge of coding compliance and regulatory standards Excellent organizational skills for initiation and… more
- Hospice of Northwest Ohio (Perrysburg, OH)
- …management. Must have knowledge of healthcare laws and regulations including Medicare Conditions of Participation and Medicare quality regulations. Proficient ... employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice… more
- TriHealth (Cincinnati, OH)
- …in Norwood Ohio. Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their health care needs in the ... contracts into required systems/vendors, and managing the provider manual; Lead all Medicare Part D operations, including managing PBM and pharmacy services vendors;… more
- Ensemble Health Partners, Inc. (Philadelphia, PA)
- …while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as ... responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information,… more
- Ensemble Health Partners, Inc. (Greenville, SC)
- …while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies ... responsible for assigning accurate MRNs, completing medical necessity or compliance checks, providing proper patient instructions, collecting insurance information,… more
- Insperity (Chatsworth, CA)
- …for the accurate and timely adjudication of CMS 1500 and UB-04 claims, ensuring compliance with Medicare and Medi-Cal guidelines. At Thrifty, we pride ourselves ... knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines. Experience with CPT-4, ICD-10-CM, RBRVS, ASA, and HCPCS, as well as… more
- CareRing Health, LLC (Philadelphia, PA)
- …Responsible for developing and maintaining tracking and reporting tools to assess Compliance Reviewing all policies, state and federal regulations and ... Overview We are looking for a Compliance Coordinator to be part of our ground-breaking...care, homecare, and hospice care - to the chronically-ill, Medicaid/ Medicare -eligible population. Our innovative healthcare delivery model will result… more
- MBK Senior Living (Huntington Beach, CA)
- …and maintain all state specific regulatory requirements - Must maintain HIPAA compliance at all times Physical Demands (Include lifting, carrying, pushing, pulling, ... Residents: An "Excluded Party" is a person that the federal or state government found not eligible to provide...provide care and services in a facility that receives Medicare or Medicaid funding. If employed at one of… more
- MBK Senior Living (Portland, OR)
- …Living Communities with Medicaid Residents: An "Excluded Party" is a person that the federal or state government found not eligible to provide care and services in a ... facility that receives Medicare or Medicaid funding. If employed at one of...Human Services, any state Medicaid Programs, and any additional federal and state government contract programs. If, as a… more
- Inland Empire Utilities Agency (Chino, CA)
- …this key role, you'll supervise and support a high-performing team, ensure compliance with legal and regulatory requirements, and implement best practices to ... have a high level of integrity, honesty, and a strong commitment to compliance and confidentiality. You enjoy leading teams and supervising work related to databases… more
- UnitedHealth Group (Minneapolis, MN)
- …employees to ensure delivery of our contractual regulatory commitments for the UHC Medicare and Retirement Health plans. Acts as the primary point of contact for ... Medicare and Retirement for new business implementation, regulatory contract...Retirement Claim functions for health plans, ensuring operational contract compliance as defined by CMS and retirement plans. You'll… more
- Ewings Associates (Medina, WA)
- …partnerships and operational efficiency. The organization is focused on expanding Medicare Advantage and commercial networks across multiple regions, requiring a ... oversee network adequacy, provider engagement, and contracting strategy while ensuring compliance requirements. This role is designed for a seasoned healthcare… more
