- CVS Health (Phoenix, AZ)
- …organization. + In partnership with and under the direction of the health plan Medicare Compliance Officer and other team members, this position will help ... elements and compliance department responsibilities required under the Medicare Compliance Program, which include but are not limited to meeting attendance,… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** ... **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more
- CareOregon (Portland, OR)
- …hired for remote positions must reside in Oregon or Washington. Job Title Medicare Encounter Data Analyst Exemption Status Exempt Department Finance Manager ... role is available to candidates residing in Oregon or Washington. Job Summary The Medicare Encounter Data Analyst leads the process for the end-to-end Encounter… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, the Medicare Advantage Premium Billing Analyst plays a vital role in ensuring accurate and ... of invoices. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail...interpret State (CA DHS) and CMS files to ensure compliance with regulations + Utilize knowledge of finance, accounting,… more
- Corewell Health (Grand Rapids, MI)
- …of the member appeal and fair hearing review processes for all Medicare products to thoroughly investigate appeal requests, leveraging critical thinking skills, ... systems, and collaboration to resolve issues whenever possible. Ensure compliance with all mandated, legislative, regulatory and accreditation requirements. Assist… more
- The Cigna Group (Nashville, TN)
- As a **Fulfillment Lead Analyst ** you would be responsible for the management of customer correspondence processes, including, but not limited to management of ... management of new and updated collaterals related to the Medicare book of business. **How you'll make a difference...templates + Manage collateral intake requests from business and compliance to ensure end to end process for appropriate… more
- Cleveland Clinic (Cleveland, OH)
- …organizations in the world. Our department is looking to add a Senior Financial Analyst to their dedicated team of caregivers. In this role, you will provide ... should have the following experience: * Prepares and files Medicare and Medicaid cost reports on a timely and...changes and proposes cost report handling. * Assists on compliance issues as required * Assists with third party… more
- The Cigna Group (Nashville, TN)
- …medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts. **Essential Duties ... medical necessity and appropriateness of setting according to established policies and compliance guidelines. + Uses an established set of criteria to evaluates and… more
- The Cigna Group (Bloomfield, CT)
- …evaluations of both internal and external agents in order to ensure compliance to CMS and Cigna rules and regulations Responsibilities + Performs monitoring ... and managers as well as external partners regarding agent/agency performance and compliance . + Maintains a strong rapport with telephonic internal and external… more
- Universal Health Services (Reno, NV)
- …the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Compliance Analyst provides support to the organization to execute ... key initiatives for the effectiveness of the Compliance Program for health plan products, including ...third-party administration, and other commercial health plan products. The Compliance Analyst captures and analyzes data used… more
- Providence (CA)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... to optimize performance + Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements + Collaborating with… more
- Dartmouth Health (Lebanon, NH)
- … regulations related to the First-Tier, Downstream and Related Entity (“FDR”) Medicare Compliance Program Guidance in collaboration with DH Corporate ... Overview The ACO Compliance Program Analyst (the “Program ...Medicare Advantage directed First-Tier Downstream Related Entity (FDR) compliance program. Administration activities will include, but are not… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Sr. Contract Compliance Analyst III Date: Jun 14, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 54798 **Who ... to key internal and external stakeholders. In addition, the Sr. Contract Compliance Analyst will participate in identifying and recommending contracting strategy… more
- CVS Health (Southfield, MI)
- …with establishing and implementing results-based programs and innovative initiatives for the Medicare compliance area, under general supervision, with a focus on ... onsite per week and two days remote The Sr. Analyst Corporate Compliance is an experienced career...and communication skills to support, manage and help develop Medicare and Medicaid compliance programs and processes… more
- State of Georgia (Fulton County, GA)
- Compliance and Reporting Analyst - State Based Exchange Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/53891/other-jobs-matching/location-only) ... Job Share this Job Sign Up for Job Alerts Under general supervision, the Compliance and Reporting Analyst , coordinates the rollout of new or updated reporting… more
- CareFirst (Baltimore, MD)
- … Professional or + Lean Six Sigma Certification-IASSC or + Certified Regulation Analyst or + Certified Compliance & Ethics Professional (CCEP) **Experience:** 5 ... compliance programs, or related fields. **Preferred Qualifications:** + Healthcare Compliance certification(s). + Experience in CMS programs ( Medicare or… more
- Randstad US (Scottsdale, AZ)
- legal compliance associate analyst . + scottsdale , arizona (remote) + posted 8 days ago **job details** summary + $25 - $28.78 per hour + temporary + bachelor ... business and financial operations occupations + referenceAB_4552479 job details The Medicare Marketing Oversight Specialist is a compliance -minded individual who… more
- University of Michigan (Ann Arbor, MI)
- HEALTH INFORMATION MANAGEMENT ANALYST II - COMPLIANCE AND AUDITING Apply Now **Summary** Utilize the EPIC Release Module to locate, analyze, and produce medical ... **Job Detail** **Job Opening ID** 250238 **Working Title** HEALTH INFORMATION MANAGEMENT ANALYST II - COMPLIANCE AND AUDITING **Job Title** Health Information… more
- University of Rochester (Rochester, NY)
- Responsibilities **Position Summary:** **This position oversees outpatient Medicare , Medicaid and third-party payor audits, and directs all responses to assure ... for all internal and external sources regarding routine audits, including Medicare and Medicaid credit balance quarterly audits, audits obtained from the… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Compliance , Legal and Security departments to meet business needs. The MDM Analyst will assist the DGO, Compliance , Legal and Security with strategy, policy ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....possible health and quality of life. Master Data Management Analyst I-IV The MDM Analyst within the… more