- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …exposure to all areas of BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker with the ability to drive ... collaboratively with both technical and non-technical staff including Underwriting, Medicare Product Development, Provider Contracting, Sales, and others across the… more
- Humana, Inc. (Fairfax, VA)
- …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
- 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
- Larson Maddox (Huntington Beach, CA)
- …of Medicare Advantage and HIPAA regulations. Minimum 5 years of experience in Medicare compliance or auditing, with at least 3 years in a leadership role. ... culturally aligned, community-focused care. This role is ideal for a compliance professional passionate about regulatory excellence and operational integrity. As the… more
- Fallon Health (Buffalo, NY)
- …business administration or related field A minimum of 2 years of regulatory compliance experience required Understanding of Medicare and Medicaid regulations a ... the Medical Loss Ratio as per organization's goal. Regulatory oversight and compliance : Develop policies/procedures and workflows for key operations and manage the… more
- Hospice Of Southern Illinois, Inc. (Belleville, IL)
- …to ensure policies and processes are compliant with local, state, and federal regulations. This position supervises the Regulatory Compliance Educator and ... Description Summary of the Regulatory Compliance Education Manager Position Goal: This position manages the planning, development, implementation and evaluation of… more
- UnitedHealth Group (Fort Washington, PA)
- …start Caring. Connecting. Growing together. The Director of Actuarial within UHC Medicare & Retirement will lead an actuarial team responsible for claim forecasting, ... Identifying and quantifying trends in medical cost drivers for Medicare Supplement products. The director will perform critical data analysis, SAS/SQL/Excel… more
- Trinity Health (Des Moines, IA)
- …basics of coding diagnoses and procedures as required for insurance authorizations and Medicare compliance . Utilizes online program for Medicare ... physician offices. Ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications and referrals. Provides excellent… more
- MBK Senior Living (Manteca, CA)
- …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
- BAYADA Home Health Care (Moorestown, NJ)
- …Manager: Provide direct supervision and support to field clinical staff Ensure compliance with Medicare Conditions of Participation (CoPs), state regulations, ... Occupational Therapist to fill the position of Rehab Manager for our Moorestown, NJ Medicare Certified, Home Health office. Do you want to be part of providing care… 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
- MBK Senior Living (Manteca, CA)
- …- Monitors monthly expenditures to include explanation of significant variances to ensure compliance with budget. - Adhere to and carry out all MBK policies and ... 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
- SCAN (Long Beach, CA)
- …possible updates due to audit results and/or change in regulations Work with the Medicare Compliance team when new regulations are released to ensure appropriate ... the Regulatory Lead with all regulatory audits (state & federal ). In this role, the Regulatory Audits & Monitoring...years' experience in managed health care required. 3+ years compliance experience Demonstrated knowledge of the Medicare … more
- Regency Integrated Health Services (Cuero, TX)
- …accurate and timely completion of resident assessments in accordance with Medicare , Medicaid, OBRA and other payer program requirements. Ensures assessments ... the referral source(s). Ensures accurate and timely completion of all Medicare /Medicaid case-mix documents to assure appropriate reimbursement for services provided… more
- StateJobsNY (New York, NY)
- …you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other ... Nurse Supervisor 1 Psychiatric and other nursing and direct care staff *Ensuring compliance with established standards of nursing care in accordance with State, … more
- ARTHRITIS & RHEUMATISM ASSOCIATES P (Washington, DC)
- …good use of body mechanics and follow safety regulations COMPLIANCE : Follow compliance requirements mandated by HFCA, Medicare and all other ARA contracted ... scheduling appointments, verifying insurance information, outside physician signature tracking, Medicare usage tracking, mailing, data entry and other duties… more
- StateJobsNY (Syracuse, NY)
- …you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other ... staffing schedules *Developing daily staffing plans for nursing care *Ensuring compliance with established standards of nursing care in accordance with State,… more
- Ensemble Health Partners, Inc. (Fairborn, OH)
- …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
- City of Tustin, CA (Tustin, CA)
- …Work: Must be legally authorized to work in the United States under federal law. Background/Character: Free from conviction of a felony or serious misdemeanor; ... and weekends. The City of Tustin is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the City will provide reasonable… more
- TemPositions Health Care (New York, NY)
- …(EHR) system to the medical billing system. Must be familiar with Medicaid, Medicare , Managed Care, etc. Submit insurance claims and follow up on claims processing ... through clearinghouses. Monitor and resolve claim denials from Medicaid, Medicare , Managed Care, and other payers. Verify patient eligibility and coverage across… more
