- Humana (Washington, DC)
- …The focus of this role is Medicare Pharmacy and Part D. The Senior Compliance Professional will analyze business requirements, provide research and ... caring community and help us put health first** The Senior Compliance Professional ensures ...Compliance or Health Plan Operations + Familiarity with Medicare pharmacy laws or regulations **Additional Information** Interview Format… more
- Humana (Washington, DC)
- …evaluation of variable factors. We are looking for an experienced Senior Compliance Professional specializing in Medicare Advantage to join our Field ... community and help us put health first** The IFG Senior Compliance Professional ensures ...cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare… more
- ERP International (Laurel, MD)
- …Engagement:** + Work closely with CMS business owners, EA team members, compliance offices, policy experts, and technical leads. + Facilitate working sessions to ... consultation on best practices for integrating emerging technologies into CMS's compliance and operational frameworks. + **Documentation and Reporting:** + Produce… more
- CenterWell (Washington, DC)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- Humana (Washington, DC)
- …between Humana and its trading partners, Medicare and Medicaid. The Senior Encounter Data Management Professional will work with department leadership, ... caring community and help us put health first** The Senior Encounter Data Management Professional develops business...Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools… more
- Prime Therapeutics (Washington, DC)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** Job Description The ... Senior Compliance Analyst assists in the implementation...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Washington, DC)
- …focus **Reporting Structure** + Reports to Sr Professional , Manager, Director or Senior Director in the Compliance department Potential pay for this position ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) -...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Washington, DC)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior ... Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) Certified Project Management Professional (PMP)… more
- Humana (Washington, DC)
- …adjustment coding and documentation accuracy. The Clinical Support Team is seeking a senior professional who will be accountable for developing and maintaining ... caring community and help us put health first** The Senior Market Consultation/Partnership Professional interprets, analyzes, and...+ Help ensure accurate review of medical records for Medicare and Medicaid Risk Adjustment + Review and respond… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Senior Vendor Management Professional works as liaison between vendors and organization. The ... Senior Vendor Management Professional 's work assignments involve...liaison between vendors, internal business owners, contracting, risk, and compliance teams. As part of the Humana Military Contract… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Senior Contract Management Professional evaluates, drafts, and negotiates contracts and other ... of goods and services for Humana, its subsidiaries and affiliates. The Senior Contract Management Professional work assignments involve moderately complex to… more
- Humana (Washington, DC)
- …community and help us put health first** Humana Healthy Horizons is seeking a Senior Program Delivery Professional to support quality program work in multiple ... Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS). The Senior Program Delivery Professional (LTSS - Quality) works on problems… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Senior Learning Design Professional uses instructional design, cognitive psychology and adult ... to determine the appropriate solution to a knowledge or performance gap. The Senior Learning Design Professional work assignments involve moderately complex to… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... data requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Senior TRICARE Community Liaison (TCL) is a customer-facing Humana Military associate who is ... knowledgeable, professional , and courteous. This role interacts in person and...Medical Treatment Facility (MTF) and other Government staff, including senior military leaders, and civilian healthcare providers and facilities.… more
- ICF (Reston, VA)
- Description ** Senior CMS Data/Policy SME** **- (Part Time)** **The Company:** ICF is a mission-driven company filled with people who care deeply about improving the ... for the customer. We are looking for a seasoned Senior Backend Engineer who will be a key driver...and guide cross-functional teams through complex policy, regulatory, and compliance landscapes. Leveraging deep expertise in CMS data and… more
- Genesis Healthcare (Kensington, MD)
- …Program, and expand your expertise with our Clinicians in Action professional development program. Responsibilities **Powerback** is a new way of delivering ... way of feeling better, moving better, breathing better, and living better. The Senior Therapist is responsible for assisting the Director of Rehab in the efficient… more
- Genesis Healthcare (Mitchellville, MD)
- …Program, and expand your expertise with our Clinicians in Action professional development program. Responsibilities The Senior Therapist is responsible ... position assists in integration of rehabilitation services in all settings. The Senior Therapist assesses the need for, develops, and delivers therapy programs to… more
- CenterWell (Washington, DC)
- …put health first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist Therapeutic Subject Matter Expert monitors drug development ... factors. **Responsibilities** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist develops, maintains, and/or operationalizes strategies related… more
- Somatus (Mclean, VA)
- …coverage (medical, dental vision) + Flexible Paid Time Off (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting ... provides guidance and oversight to all lines of business including Commercial, Medicaid, Medicare , and Special Need Plans (SNPs). The Sr. Manager, Quality will work… more