- Molina Healthcare (Dallas, TX)
- …relative to Molina Medicare . The Director is co-chairman of the Molina Medicare Compliance Committee. The Director , working with the MHI VP ... Compliance , is accountable to the Molina Medicare Compliance Committee for all ...implementation and maintenance of the Molina Medicare Compliance Plan and audit activities. The Director … more
- Molina Healthcare (Dallas, TX)
- …or related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with ... **Job** ** ** **Summary** Safeguard member trust and plan compliance by owning Molina's entire CMS Complaints Tracking Module...entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the… more
- Molina Healthcare (Dallas, TX)
- …of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops ... infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and… more
- Molina Healthcare (Dallas, TX)
- …of Coverage for print and online distribution via the iCat authoring process, ensuring compliance with CMS guidelines. Support Medicare and MMP line of business ... completion including adhoc projects and submissions as assigned by the Director of Medicare Programs. **KNOWLEDGE/SKILLS/ABILITIES** + Initiate projects by… more
- Texas Health Resources (Dallas, TX)
- ** Director Compliance and Privacy - Texas Health Physicians Group** _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? ... THPG a great place to work. **Job Description** ORGANIZATION AND OVERSIGHT - COMPLIANCE AND PRIVACY PROGRAMS: Oversee, lead and administer the THPG Compliance … more
- Aveanna Healthcare (Fort Worth, TX)
- RN Clinical Director ApplyRefer a FriendBack Job Details Requisition #: 204171 Location: Fort Worth, TX 76102 Category: Nursing Salary: $80,000.00 per year Position ... Details Position: Clinical Director (RN) ( Director of Nursing) Join a...evaluate the nursing service department's programs and activities, ensuring compliance with state, federal, and local regulations. + Coordinate… more
- The Cigna Group (Plano, TX)
- …including strategic direction, project support of technical requirements to ensure ongoing compliance , Center for Medicare and Medicaid (CMS) Audit support and ... **Job Description: Director for Regulated Markets - CDAG/ODAG** **Excited to...Markets is responsible for Coverage Review and Determinations for Medicare Part B and Part D, Medicaid, Marketplace or… more
- Jet Health (Fort Worth, TX)
- …program to ensure accuracy and regulatory fulfillment of timely documentation. + Compliance :Focus on Medicare Quality Measures and other industry standards to ... Director of Clinical Services - Home Health Fort Worth, TX...ensure compliance . + Staffing:Ensure that staffing ratios are sound, and patient focused.… more
- Molina Healthcare (Dallas, TX)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Plans, organizes, ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Elara Caring (Dallas, TX)
- …Health, and Personal Care Services (PCS) agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations and billing rules. Areas of ... + Reliable transportation to perform job tasks You will report to the Director of Compliance Audit. _We value the unique skills of veterans and military spouses.… more
- Fresenius Medical Center (Plano, TX)
- …and Follow up teams to assure proper direction is obtained. + Assuring compliance with Medicare /Medicaid requirements and regulations by: + Maintaining current ... values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS/USV/FVC policy...knowledge on Medicare , Federal, State and local regulations including reimbursement and… more
- Molina Healthcare (Dallas, TX)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations ... between Molina Healthcare and contracted provider network. In partnership with Director , manages and coordinates the Provider Services activities for the state… more
- Molina Healthcare (Dallas, TX)
- …and appropriate outreach and coordination of services, including MTM services for Medicare and Medicaid eligible members as well as Medication Adherence Programs for ... to ensure prompt resolution of identified issues. * Ensures compliance with all CMS guidelines and reporting requirements for...to drug therapy were implemented. * Assists Manager or Director in the collection and tabulation of data for… more
- CenterWell (Grand Prairie, TX)
- …medical expertise with the care team through daily huddles. Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by ... local primary care "on-call" program of CenterWell as needed. Assures personal compliance with licensing, certification, and accrediting bodies. Spend 100% of your… more
- CenterWell (Plano, TX)
- …of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Molina Healthcare (Dallas, TX)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid) Executes health plan's member and community quality ... opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation...or Healthcare Administration + 1 year of experience in Medicare and in Medicaid managed care + Certified Professional… more
- Molina Healthcare (Dallas, TX)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation...skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with… more