- Humana (Trenton, NJ)
- …to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, and Abuse in a ... a group of seasoned professionals. + Proven knowledge in Medicare regulations + Excellent PC skills MS Excel and...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Trenton, NJ)
- …industry in how digital can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are aggressively driving new digital ... of working, and employing next-gen technology to revolutionize how Medicare Advantage is sold. This role is part of...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Virtua Health (Moorestown, NJ)
- …ambulatory medical setting. Knowledge of insurance (ICD-9 CPT coding, Medicare regulations, state regulations, CLIA, DOH, and OSHA regulations) preferred. Solid ... If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than… more
- RWJBarnabas Health (Oceanport, NJ)
- …and DRG assignment for adherence to Federal and State Regulations and Compliance Guidelines. + Critically analyzes each inpatient medical record to apply ... sustain an excellent organizational average accuracy rate. Adherence to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines… more
- Sunrise Senior Living (Edison, NJ)
- …care of the guest/resident through the Care Plan process. **Quality Assurance, Regulatory Compliance ** + Maintain knowledge of the Federal and Sunrise Quality ... programs during the required timeframe. + Develop a working knowledge of federal and state/provincial regulations and ensures compliance through supervising and… more
- WTW (Fort Lee, NJ)
- …Stay updated on federal , state, and local payroll regulations to ensure compliance * Provide support in the design and analysis of employee compensation plans ... leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental… more
- CVS Health (Trenton, NJ)
- …Health Plan Clinical Advisor will collaborate with CVSH internal partners to ensure compliance to any federal , state or local regulatory requirements that impact ... These include the health plan's pharmacy support team, pharmacists, medical directors, CMO as well as other senior health...up to 4 market segments for any particular client ( Medicare , Medicaid, Exchange, and or Commercial). The Health Plan… more
- CenterWell (Trenton, NJ)
- …are excited to offer the role of Virtual Physician Collaborator for CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary ... are excited to offer the role of **Virtual Physician Collaborator for CenterWell Medical Group** , a new virtual care delivery group within CenterWell Senior Primary… more
- Gentiva (Laurel Springs, NJ)
- …+ Direct overall hospice branch operations, ensuring compliance with state, federal , and accreditation standards (CMS, Medicare , Joint Commission, etc.) + ... health, or healthcare operations leadership + Strong understanding of hospice regulations, compliance , and Medicare conditions of participation + Proven ability… more
- CVS Health (Trenton, NJ)
- …and prosecution of health care fraud to recover lost funds. Responsible for compliance with state and federal regulations mandating the reporting of corporate ... experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and written… more