- Novo Nordisk Inc. (Plainsboro, NJ)
- …implementation of 340B as well as Inflation Reduction Act ("IRA") processes and compliance activities for the Medicare Drug Negotiation Program. Ensures accurate ... Supports special projects for all US government programs to assist with compliance and implementation of new and existing regulations. Relationships Reports to the… more
- Merck & Co. (North Wales, PA)
- Job DescriptionField Access ManagerThe Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals (HCPs) ... reimbursement issues, and support patient assistance programs, all while ensuring compliance with healthcare regulations.The FAM role is a remote/field-based role… more
- Lundbeck (Miami, FL)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/ Compliance ... transform lives. Join us on our journey of growth! As a Psychiatry Account Manager , you lead the promotion of our psychiatry portfolio, executing sales and marketing… more
- Merck & Co. (North Wales, PA)
- …management, or reimbursement support- Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related access processes, including ... verification, prior authorization, and appeal processes- Expertise in pharmaceutical compliance and HIPAA regulations regarding patient confidentiality- Excellent interpersonal… more
- Lundbeck (Chicago, IL)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/ Compliance ... to stakeholders in the primary care and neurology settings. As an Account Manager , you lead the promotion of our psychiatry portfolio, executing sales and marketing… more
- Merck & Co. (Los Angeles, CA)
- …with the in-scope customer team: Customer Team Leader, Key Account Manager , Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, ... and long-term plans in collaboration with the local team and district manager (known as the Oncology Customer Team Leader).Ask insightful questions to understand… more
- Medical Mutual of Ohio (OH)
- …responsible for leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage ... **Responsibilities:** + Manages the implementation and operation of the Medical Mutual Medicare Compliance Program. + Serves as Medical Mutual's Medicare … more
- CVS Health (Downers Grove, IL)
- …environment with a current focus on integrated special needs plans. The Sr. Manager Compliance maintains productive relationships and open lines of communication ... heart, each and every day. **Position Summary:** The Sr. Manager is an experienced/career level compliance position...compliant outcomes + Monitor and audit as outlined in Medicare Compliance Work Plan and direct other… more
- CVS Health (Albany, NY)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... market performance, cost structure and local execution of medical costs management, compliance , and revenue integrity efforts for all Medicare Advantage products… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medicare Broker Relations Manager drives broker channel growth and ensures sales success. This position is responsible for cultivating and ... with independent brokers and general agencies, while ensuring full compliance with Centers for Medicare & Medicaid...while ensuring full compliance with Centers for Medicare & Medicaid Services (CMS), state, and internal regulations.… more
- Houston Methodist (Katy, TX)
- …Access Services, and Utilization Review as needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… more
- CVS Health (St. Louis Park, MN)
- …it all with heart, each and every day. **Position Summary** As the **Senior Manager of Stars** , you will lead the market-wide strategy, performance improvement, and ... execution of the Medicare Stars quality program...(HEDIS, Clinical Operations, Network, Pharmacy, Product, Member Experience, Data/Analytics, Compliance ) to implement evidence-based interventions. + Partner with external… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Humana (Miami Lakes, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Fallon Health (Springfield, MA)
- …in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more
- Atlantic Health System (Morristown, NJ)
- The Compliance and Privacy Manager oversees, in pertinent part, the following compliance risk areas: (i) general compliance and compliance program ... privacy, information governance, and data risk classification; (iv) accountable care organization compliance ; (v) Medicare C & D/ Medicare Advantage … more
- Texas Health Resources (Arlington, TX)
- Manager Compliance Coding _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like ... + Core work hours: Monday - Friday; 8:00a-5:00p; Position Summary The Coding Compliance Manager oversees and manages auditing and monitoring activities related… more
- Project Renewal, Inc. (New York, NY)
- Title: Senior Manager , Compliance Program: Legal, Varick Headquarters Salary Range: $90,000 - $100,000 per year Overall Responsibilities: The Senior Manager , ... in healthcare and related human services. The Senior Manager , Compliance reports to the Director of...state, and local healthcare regulations (eg, HIPAA, Stark Law, Medicaid/ Medicare , Part 2). + Ensure the organization's compliance… more
- Muckleshoot Indian Tribe (Auburn, WA)
- JOB SUMMARY The Health Information Systems & Compliance Manager oversees the accuracy, security, and compliance of patient health information while leading a ... key link between clinical, administrative, and IT teams, the manager strengthens data integrity, compliance readiness, and...and prepare for external regulatory reviews to maintain full compliance with CMS, Medicare , Medicaid, and state… more
