- Molina Healthcare (Miami, FL)
- …functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide ... management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for … more
- ChenMed (Miami, FL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management… more
- ChenMed (Miami, FL)
- …contracts and instruments. + Ability to independently manage complex regulatory compliance matters which pose significant risk to the organization. + Regularly ... on the Stark Law, Anti-Kickback Law and other federal and state healthcare compliance matters, and drafting complex agreements and other legal documents. + Excellent… more
- ChenMed (Lakeland, FL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable center and market leadership to ensure compliance with guidelines along with participating in risk and quality management programs,… more
- Cardinal Health (Tallahassee, FL)
- …initiatives to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage ... for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends in denials and… more
- Humana (Miramar, FL)
- …for individual patient orders. + Coordinates all supplies recall activities and assures compliance with FDA and company policies for same if applicable. + Maintains ... records of all routing. + Performs vehicle maintenance to assure compliance with manufacturer's and company fleet management specifications. + Delivers equipment… more
- Humana (Tallahassee, FL)
- …pillars, including continuous integration (CI), continuous delivery (CD), quality, security, compliance , metrics, and reporting. + Ensure compliance with ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- AdventHealth (Palm Coast, FL)
- …expansion of accountable service-lines across region/division, as applicable ** COMPLIANCE /REGULATORY RESPONSIBILITY:** + Accountable for assuring compliance ... of performance with the State of Florida regulatory agencies, basic Centers for Medicare & Medicaid Services (CMS) regulations, as well as other local, state, and… more
- Fresenius Medical Center (Tallahassee, FL)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and… more
- CVS Health (Tallahassee, FL)
- …oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and objectives for ... Member Outreach, Care Management, National Quality Management, Utilization Management, Compliance , and other departments to integrate social, behavioral, and… more