- Humana (Trenton, NJ)
- …segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare… more
- Prime Therapeutics (Trenton, NJ)
- …with specific emphasis on Medicare Part D and Managed Medicaid. The Sr Director , Pharm Trade Relations leads a team of directors and/or Sr directors and is ... Sr Dir Pharmacy Trade Relations - Remote **Job Description** The Sr Director , Pharmaceutical Trade Relations is responsible for managing Prime's Trade Relations… more
- Sunrise Senior Living (Edison, NJ)
- …follows Resident Centered Care model. + Assists with case management of both Medicare and non- Medicare guests/residents as needed. + Participates in the Care ... of guests/residents charts. + Completes Incident Reports and reports to Director of Nursing Services (DNS). + Reviews, updates and documents communication… more
- Atlantic Health System (Morristown, NJ)
- …computerized records Job Function 08: Provides consultation and education for medical staff, and other allied professionals. Coordinates clinical assignments and ... department. Dual Reporting * Educator directly reports to Unit Director /Manager * Educator has dotted line report to Nursing...Our facilities and sites of care include: + Morristown Medical Center, Morristown, NJ + Overlook Medical … more
- Atlantic Health System (Morristown, NJ)
- …issues, including fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid compliance, licensure issues, pay-to-play issues, corporate governance ... regulatory and corporate work experience, including prior experience with hospitals, Medicare and Medicaid, and federal and state healthcare regulatory issues,… more
- Hackensack Meridian Health (Edison, NJ)
- …audits for medical provider documentation while adhering to Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General (OIG) guidelines for ... skills. + High-level understanding of coding and auditing concepts, American Medical Association (AMA)/Centers for Medicare and Medicaid Services (CMS)/Office… more
- Cardinal Health (Trenton, NJ)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Humana (Trenton, NJ)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... experience in revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of… more
- Serenity Hospice Care (Paramus, NJ)
- …a collaborating physician. + Consults with the patient's attending physician, the medical director and other healthcare practitioners regarding the patient's ... total needs of patients and family/caregiver + Makes recommendations to the Medical Director regarding patient eligibility for certification and recertification… more
- Atlantic Health System (Newton, NJ)
- …and adherence with corrective action plans and reports findings to the Director of Quality and Patient Safety or designee. 4. Regulatory Compliance: Participates ... such Joint Commission, State Department of Health, Centers for Medicare and Medicaid, payers and other agencies. Provides support...Our facilities and sites of care include: + Morristown Medical Center, Morristown, NJ + Overlook Medical … more