- Humana (Albany, NY)
- …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
- University of Rochester (Brighton, NY)
- …Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS , Medicare Advantage and New York State Medicaid). + Manage disputes, risks ... and Compliance on relevant reimbursement and billing issues and requirements (including CMS , Medicare Advantage, and New York State Medicaid). Stays abreast of… more
- Oracle (Albany, NY)
- …applications and dashboards that run in our clients EHR (Electronic Health Record) system to enable our clients' to track compliance with the requirements of the ... Centers for Medicare & Medicaid Services ( CMS ) and The Joint Commission (TJC). The compliance rate...you to work closely with multi-functional teams, including product management , submissions operations teams, and other software development teams… more
- Highmark Health (Albany, NY)
- …clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services ( CMS ) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. ... Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses… more
- Independent Health (Cheektowaga, NY)
- …are met. The Specialist will be responsible for compliance/adherence to CMS sales and marketing guidelines. They must demonstrate consultative sales techniques ... knowledge of complete line of products and services and CMS guidelines to provide a solution to meet those...Specialist will be responsible for 100% compliance with all CMS corporate requirements. **Qualifications** + High school diploma or… more
- JPMorgan Chase (New York, NY)
- …brand standards, rights/licensing, accessibility, privacy-by-design, and audit requirements in content operations. + Vendor/consultant management for martech and ... We're seeking a highly innovative AI transformation leader for content and creatives. Your mission is to modernize and automate end-to-end content production… more
- Catholic Health Services (Rockville Centre, NY)
- …to improve outcomes and efficiency. + Lead process redesign and change- management efforts to improve quality, efficiency and experience. Clinical Quality & ... Regulatory Compliance + Ensure 100% compliance with CMS , state survey agencies, and Joint Commission standards. + Achieve and maintain 5-Star CMS ratings across… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …total, organizes analyses to support recommendations. + Leads preparation of accruals/liabilities for CMS Part D risk sharing and Part C revenue settlements. + Leads ... Insurance Department. + Oversees the submission and quality of NYS and CMS regulatory encounter submissions and supports all required audits, internal and external… more
- Humana (Albany, NY)
- …and work is assisted by diverse resources, included but not limited to CMS policies, National and Local Coverage Determinations, CMS -recognized Compendia, NCCN, ... participation in hearings involving an Administrative Law Judge, support for CMS audits, cross-functional team activities, and other responsibilities as determined… more
- Dow Jones (New York, NY)
- …into functional digital experiences. + Demonstrate a working knowledge of CMS tools, including WordPress, to support the production of scalable, maintainable ... iterate websites and digital touchpoints that align with UX principles and CMS requirements. + Champion brand consistency and elevate visual design standards across… more