- Centene Corporation (Jefferson City, MO)
- …regulatory forms, reports, and data. + Tracks all sales issues referred to the Medicare Compliance Department up to and including resolution. + Performs special ... home anywhere in the Continental United States **Position Purpose:** Supports the Medicare Sales Compliance team in the management of regulatory requirements… more
- CVS Health (Lansing, MI)
- …and influence ethical and compliant outcomes * Monitor and audit as outlined in Medicare Compliance Work Plan and direct other projects as assigned to evaluate ... communication skills to support, manage and develop and execute Medicare and Medicaid compliance programs and processes...and develop and execute Medicare and Medicaid compliance programs and processes that promote compliant and ethical… more
- SUNY Upstate Medical University (Syracuse, NY)
- …resources. Ensure accurate coding and documentation to support quality initiatives and Medicare compliance . Work closely with clinical teams across seven Primary ... Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care clinics. This role… more
- BroadPath Healthcare Solutions (Honolulu, HI)
- …and presentation skills-comfortable leading high-energy classroom environments + Experience in Medicare sales, healthcare, or compliance -driven environments is a ... **Overview** **Train. Coach. Elevate.** **Become a Medicare Telesales Trainer** **Kapolei, Hawaii** **Hybrid Role | $30/hr. | Career-Defining Opportunity** Are you a… more
- Commonwealth Care Alliance (Boston, MA)
- …reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and Analytics ... under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing… more
- CVS Health (Hartford, CT)
- …monitoring and tracking and Utilization Management Strategy support * Collaborative work with Medicare Quality and Compliance on an ongoing basis * Develop ... Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part C...subject matter expertise on Medicare policy for the enterprise * Provide ongoing education… more
- CVS Health (Hartford, CT)
- …a rotational basis to support 72 hour turn around time * Collaborative work with Medicare Quality and Compliance on an ongoing basis * Provide ongoing education/ ... this Medical Director role are related to Part C Medicare Appeals. This position is primary on the non-regulated...cross train for regulated appeals. * Provide support to Medicare appeal nurses * Provide after hours and weekend… more
- Independent Health (Buffalo, NY)
- …to market annual sales plan. + Develop, deliver, test, and monitor effective Medicare products, sales, and compliance training programs for all individuals who ... fosters growth, innovation and collaboration. **Overview** The Training and Product Specialist- Medicare , Senior will be responsible for the design and development of… more
- CVS Health (St. Louis Park, MN)
- …market performance, cost structure and local execution of medical costs management, Medicare Stars, member engagement, compliance , and revenue integrity efforts ... more valuable health insurance solution for Minnesotans. Our Allina Health/Aetna Medicare health plan currently serves approximately 27,000 Medicare … more
- Dana-Farber Cancer Institute (Brookline, MA)
- …of research activity in an academic medical center + Knowledge of billing compliance and Medicare regulations/policy, applicable federal, state, and local laws, ... fully remote with the ocassional time onsite as needed.** The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed… more
- Medical Mutual of Ohio (OH)
- …health plan clinical operations which includes work in government programs ( Medicare ) compliance , regulatory audits and process improvement. **Professional ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Acts as a subject… more
- Centene Corporation (Raleigh, NC)
- …and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads ... Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance ...(and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to inquiries from state… more
- City of New York (New York, NY)
- …a variety of topics, including legal ethics, conflicts, privileges, federal grants, Medicare compliance , and outside employment. Division attorneys also conduct ... position of Assistant Corporation Counsel in the Ethics & Compliance Division. Attorneys with more than five years of...Senior Counsel position in the division. The Ethics & Compliance Division has counseling and ligation adjacent roles and… more
- Tufts Medicine (Burlington, MA)
- …11. Develops and implements corrective action plans for identified issues of non- compliance related to Medicare programs. 12. Standardizes and leads weekly ... Corporate Headquarters. **Job Overview** This position focuses on the Medicare Shared Savings Program (MSSP) and Medicare ...the Medicare Shared Savings Program (MSSP) and Medicare Advantage programs, plays a crucial role in overseeing… more
- Ultimate Care Inc (Brooklyn, NY)
- …that clinical documentation meets Medicare requirements for skilled services. + Medicare Compliance : Stay informed about Medicare billing regulations and ... Specialist will be responsible for managing the billing and collections process for Medicare /Medicaid Managed Care claims. You will work closely with our finance and… more
- City of New York (New York, NY)
- …a variety of topics, including legal ethics, conflicts, privileges, federal grants, Medicare compliance , and outside employment. Division attorneys also conduct ... Job Description The Ethics and Compliance Division is hiring a supervise to assist...assigning work and reviewing their work. The Ethics & Compliance Division has counseling and ligation adjacent roles and… more
- Centene Corporation (Jefferson City, MO)
- …lines of business. Responsibilities include intaking and triaging suspected issues of non- compliance , entry of compliance issues into GRC tool and ... assignment/coordination of issues to corrections team members; collaborating with compliance and business stakeholders to gather information, develop corrective… more
- Prime Healthcare (Redding, CA)
- …in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Medicare -Medicaid. This includes maintaining the ... California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Senior Medicare -Medicaid Biller/Collector is responsible for both… more
- Prime Healthcare (Ontario, CA)
- …in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Medicare -Medicaid. This includes maintaining the ... for California Applicants:https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Senior Medicare -Medicaid Biller/Collector is responsible for both… more
- Commonwealth Care Alliance (Boston, MA)
- … Medicare , and commercial payment methodologies and supports audit, compliance , and provider engagement initiatives. This role also provides support in ... have direct reports. **Essential Duties & Responsibilities:** + Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms,… more
Related Job Searches:
Associate Director Compliance Medicare,
Compliance,
Compliance Medicare Specialist,
Director Medicare Compliance,
Federal Medicare Compliance,
Manager Compliance Medicare,
Medicare,
Medicare Compliance Auditor,
Medicare Part D Compliance,
RN Medicare Compliance