- 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 ... LinkedIn; Facebook; and Twitter. The Job Supports the Audit Lead with all regulatory audits & readiness activities. This...years' experience in managed health care required. 3+ years compliance experience Demonstrated knowledge of the Medicare … more
- Homeward (Chicago, IL)
- …The Opportunity Homeward Health's creative team is seeking a talented Senior Content Specialist and copywriter to truly own and lead our messaging primarily ... that have historically limited access and quality. Homeward supports Medicare -eligible beneficiaries by partnering with health plans, providers, and communities… more
- MJHS (New York, NY)
- … lead management and outgoing member calls. The Senior Sales Operations Specialist manages and runs Elderplan Compliance Data Exclusion Reports; provides ... affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of… 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
- Essen Medical Associates (Bronx, NY)
- …you a credentialing pro with a passion for precision and process? Ready to lead impactful work that keeps healthcare running smoothly? We're looking for a Senior ... of our Payor Enrollment process and help drive efficiency, compliance , and excellence across our growing provider network. We're...highly organized, detail-obsessed, and mission-aligned If you're ready to lead with impact and be part of a dynamic,… more
- City of Longmont, Colorado (Longmont, CO)
- …are included such as Jury & Witness Duty, Sick Leave, Social Security, and Medicare . Open Until Filled positions may close without advance notice. To be considered, ... involves supervising the training and performance of swim instructors, ensuring compliance with water safety protocols, and creating an effective learning… more
- Los Angeles Metro (Los Angeles, CA)
- …the review of project submittals with the goal of achieving compliance with Metro standards, directives, and project objectives. Recruitment Timelines: Interviews ... RFI (request for information), and DDR (detailed design review) for compliance with codes, project specifications, and Metro criteria Reviews designs for… more
- Banner Health (Wickenburg, AZ)
- …that aren't available at other agencies - a field preceptor, an IT specialist , a dedicated scheduler, a nurse preceptor during orientation (available every day to ... than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. POSITION SUMMARY This...physician orders and the nursing plan of care, in compliance with policies and procedures, standards of care, and… more
- COMMUNITY HEALTH GROUP (Chula Vista, CA)
- …(DHCS), the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid (CMS), and based on evidence-based standards of practice. ... Quality Nurses, the Grievances and Appeals Supervisor, and the Corporate Quality Specialist in the performance of their role and position description. Oversees and… more
- BlueCross BlueShield of North Carolina (NC)
- …complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). **What You'll Do** + Analyzes necessary documentation, ... coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses all resources...Medicaid Services (CMS). + Uses all resources to ensure compliance and understanding of the CMS Hierarchical Condition Category… more
- PruittHealth (Norcross, GA)
- …concepts, and skills; Seeks and responds to regular performance feedback from team lead and provides upward feedback, as needed. 15. Assists in orientation and ... 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… more
- Trinity Health (Livonia, MI)
- …and periodic risk assessments in support of the Trinity Health Integrity & Compliance Program (ICP). Risk assessments consider legal and regulatory compliance ... Health & Human Services (DHHS) - Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), Department of Justice (DOJ) as well as input… more
- HonorHealth (AZ)
- …competencies include project management, clinical trial operations, coding/billing compliance , Medicare coverage analysis/budgeting, contracting, Clinical Trial ... basic finance and accounting principles. The successful Senior Clinical Trial Operations Specialist will lead and coordinate the activities of a… more
- Aveanna Healthcare (Dallas, TX)
- Healthcare Administrative Specialist ApplyRefer a FriendBack Job Details Requisition #: 205019 Location: Dallas, TX 75287 Category: Administrative/Clerical Salary: ... $13.00 - $15.00 per hour Position Details Position: Operations Specialist (Medical Records Specialist ) Join a Company That Puts People First! Aveanna Healthcare… more
- Molina Healthcare (Vancouver, WA)
- …supports continuous improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other ... departments. **Job Duties** + Acts as a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists… more
- WellSpan Health (York, PA)
- …Peer Specialist . + Completes no less than 8 billable shadowing hours with a Lead Certified Peer Specialist . + Completes and passes the required PCB exam for ... Life Skills training. + Completes a 75-hour approved Peer Specialist training within 8 weeks of hire date. +...strategies. + Completes yearly annual safety education modules in compliance with WellSpan Philhaven policy. + Performs and participates… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Trinity Health (Albany, NY)
- …Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote **POSITION PURPOSE:** ... The Risk Adjustment Coding Specialist works in a team environment and is responsible...adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND… more
- Organon & Co. (Plymouth Meeting, PA)
- …highly skilled and experienced professional to join our team as the Senior Specialist of Contract and Reimbursement Strategy. This role is essential in developing ... in facility and healthcare provider reimbursements by payer type, including commercial, Medicare , and Medicaid. The role will also support the development of a… more
- Cleveland Clinic (Garfield Heights, OH)
- …a rewarding, lifelong career in a diverse and welcoming environment. As a SQPE Specialist II, you will lead safety, quality and experience efforts by focusing ... A caregiver in this role serves as a Stroke Coordinator-ensuring compliance with stroke certification standards and promoting continuous improvement-and supports… more
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