- OhioHealth (Columbus, OH)
- …and in our communities. **Job Description Summary:** The Senior Research Finance Consultant for OhioHealth Research Institute (OHRI) will manage the full life cycle ... and varied fiscal administrative support functions such as analyzing Medicare Coverage Analysis documents, developing comprehensive internal study budgets,… more
- WellSense (NH)
- …for our members, no matter their circumstances. **Job Summary:** The Provider Relations Consultant - NH will act as the primary liaison between Provider Relations ... Consultants and internal Plan departments such as Claims, Benefits, Audit , Member and Provider Enrollment and Clinical Services to effectively identify and resolve… more
- WellSense (MA)
- …between provider and internal Plan departments such as Provider Enrollment, Claims, Audit , Marketing, Customer Care and Care Management. **Our Investment in You:** . ... and administering contractual provisions of provider agreement to ensure contractual compliance ** + **Manages flow of information to and from provider offices**… more
- US Tech Solutions (May, OK)
- …to obtain additional information. + Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines. + ... information into a clear and precise clinical picture while working independently.-Reports audit or clinical findings to appropriate staff or others in order to… more
- Stanford Health Care (Palo Alto, CA)
- …and policy governance process. + Prepares annual and ad hoc reports for the Audit and Compliance Committee of the hospitals' Board of Directors. + Develops ... is a Stanford Health Care job.** **A Brief Overview** Manages daily Compliance Program Management operational activities, key compliance initiatives, … more
- Community Wellness Partners (Oswego, NY)
- …collects and assesses information for the health and well-being resident in Medicare or Medicaid-certified beds. Complies with Federal and State requirements for all ... will assist with completing nursing assessments. 6. Ensure legal compliance for the facility by following the MDS Process....ARD 13. Maintains and develops on-going MDS schedule 14. Audit and analyze MDS data for accuracy 15. Works… more
- NHS Management, LLC (Athens, AL)
- …Specialist Consultants, Internal Auditor, or any other corporate or regulatory compliance consultant . Communicates progress toward goals and ongoing obstacles ... Specialist Consultants, Internal Auditor, or any other corporate or regulatory compliance consultant . Communicates progress toward goals and ongoing obstacles… more
- CenterWell (Seneca, SC)
- …to individual clinicians about patient terminations, in + collaboration with Compliance + Supporting clinicians with schedule templates, coverage, daily issues + ... and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality care and...**Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …review program which promotes effective cost recovery, quality of care and/or compliance with relevant federal and state laws, regulations and standards. In the ... care facilities for purposes of maximizing reimbursement revenue via Medicare Part B programs; + May review medical records...May testify in court; + May coordinate review and audit of occupational injury and/or disease disability cases for… more
- University of Southern California (Los Angeles, CA)
- …interpretation of new or revised standards; Recommends methods/actions to achieve regulatory compliance ; Serves as a consultant for other projects as assigned. ... to providing written responses to any RFI's (Recommendation for improvement), or audit deficiencies related to regulatory compliance . Ensures that the applicable… more
- State of Colorado (Pueblo, CO)
- …RN Critical Incident/Occurrence Reporter ensures documentation supports regulatory reporting, compliance , and continuous quality improvement efforts. + For each ... in the annual assessment of secured report file locations to ensure 100% compliance with record retention standards; purge and destroy expired reports using the… more
- MyFlorida (Gainesville, FL)
- …for the coordination, development, and implementation of nursing procedures in compliance with professional nursing standards, the Joint Commission on Accreditation ... Agency for Health Care Administration, and the Centers for Medicaid and Medicare Services. + Performs periodic quality care reviews and develops, implements, and… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …on matters regarding progression of patient care, medical necessity, compliance with regulatory guidelines, payer relationships; clinical documentation integrity, ... with Hospital objectives related to quality care of patients, regulatory compliance , and utilization management (including LOS). 4. The Physician Advisor should… more
- Nuvance Health (Danbury, CT)
- …committees to meet established goals for physician participation and compliance with expectations. *Responsibilities:* * Provides physician leadership for physician ... denial management issues, and potentially quality issues. * Functions as a consultant and resource to other Physician Advisors and primary (attending) physicians. *… more