- Humana (Sacramento, CA)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual ... by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts.… more
- CVS Health (Sacramento, CA)
- …codes that are submitted to the Centers for Medicare and Medicaid Services ( CMS ) for the purpose of risk adjustment processes are appropriate, accurate, and ... process audits to ensure compliance with internal policies and procedures and existing CMS regulations. + Ability to work independently as well as in a cross… more
- Oura (San Francisco, CA)
- …sustainability targets. This role requires a blend of technical expertise, project management capabilities, and a passion for environmental stewardship, all aimed at ... optimization, sustainable fuels, and route efficiencies. + Circular Economy & Waste Management : + Customer Returns & E-waste: Develop and manage programs for… more
- Pearl Interactive Network (Sacramento, CA)
- …GovWin, FedBizOpps (FBO), Federal Procurement Data System (FPDS), and the System for Award Management (SAM). + Strong leadership skills with experience ... Develop and refine a 3-year growth roadmap covering target federal agencies ( CMS , VA, HHS, SSA, DOD), state agencies (including Medicaid/Exchange programs) and… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …benefits, encouraging individual growth and development, and incorporating our CARES values system into our daily operations, we are creating a workplace culture ... maintenance, life safety systems, security systems, environmental compliance, and vendor management to ensure a safe, effective, and efficient environment for… more
- Dignity Health (Sacramento, CA)
- …to the facility compliance with Hospital Accreditation Standards, State and CMS regulations. Identifies and implements updates to the Infection Prevention Program ... and mandatory reporting to local and state health departments, NHSN, CMS , etc. + Maintains current knowledge of infection prevention professional society… more
- Humana (Sacramento, CA)
- …by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient or post-acute care… more
- Datavant (Sacramento, CA)
- …combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be accountable for ensuring our products deliver ... customer outcomes, regulatory drivers, and market trends in risk adjustment, care management , and provider enablement. + Identify and prioritize use cases that… more
- UCLA Health (Los Angeles, CA)
- …responsible for building and maintaining charge master records for the hospital system . You'll ensure that hospital charges are processed promptly, accurately, and ... in compliance with Centers of Medicare & Medicaid Services ( CMS ), Medi-Cal, and other policies. You'll apply your extensive...with EPIC charge master and familiarity with CDM structure, content , and maintenance, as well as in revenue integrity… more
- WelbeHealth (Los Angeles, CA)
- …refine risk-adjusted revenue projections for Medicare-Medicaid dual-eligible populations, incorporating CMS and state methodologies + Own and enhance methodologies ... ensure financial stability and regulatory compliance + Monitor and interpret CMS , state, and Medicaid regulatory changes impacting reimbursement rates, risk scores,… more