- Molina Healthcare (San Antonio, 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 (San Antonio, 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 (San Antonio, 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 (San Antonio, 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
- HCA Healthcare (San Antonio, TX)
- …eligible. **Introduction** Do you have the career opportunities as a(an) Division Director of Regulatory Compliance you want with your current employer? ... colleagues. Do you want to work as a(an) Division Director of Regulatory Compliance where your passion...role provides oversight for matters including the Centers for Medicare and Medicaid Services (CMS), The Joint Commission (TJC),… more
- Molina Healthcare (San Antonio, 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
- Molina Healthcare (San Antonio, 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 (San Antonio, 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 (San Antonio, TX)
- …expertise with the care team through daily huddles. + Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by ... "on-call" program of Conviva as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend...required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Minimum of two to five… more
- CenterWell (San Antonio, TX)
- …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 Conviva as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your… more
- HCA Healthcare (San Antonio, TX)
- …of the organization and meets the requirements or regulations of JACHO, Medicare , Medicaid, and appropriate licensing or certified boards. The supervisor is ... a therapist in the specific discipline of the supervisor. 4. Ensures Compliance with the conditions of participation, requirements or regulations of the following:… more
- Molina Healthcare (San Antonio, 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 (San Antonio, 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
- Gentiva (San Antonio, TX)
- …Manager** to join our team. You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible for ... developing associates and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory agencies. +… more