- Prime Therapeutics (Madison, WI)
- …pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulations + Represent Network Management department in audits and ... Ensure all contractual obligations are in adherence with company policies, regulatory compliance and legal requirements and engage with Legal and Network Management… more
- Fresenius Medical Center (Fitchburg, WI)
- …core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Functions ... nurse in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies.… more
- Molina Healthcare (Kenosha, WI)
- …reviews and appeals. * Supports behavioral health committees for quality compliance . * Implements behavioral health specific clinical practice guidelines and medical ... review criteria. * Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for … more
- Humana (Madison, WI)
- …clearly-especially around generative AI. Design for scalability, reliability, and compliance . + **MLOps & DevOps Collaboration** Work with engineering and ... 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
- Marshfield Clinic (Beaver Dam, WI)
- …and procedures and individualizes them to meet patient needs to maintain compliance with organizational, state and federal policy and to maintain patient ... been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately… more
- Marshfield Clinic (Weston, WI)
- …System (MCHS). This individual is accountable for daily operations, regulatory compliance , personnel management, budgeting, safety, and production of high quality ... been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately… more
- Molina Healthcare (Kenosha, WI)
- …review. The position may also work with other internal departments, including Compliance , Corporate Legal Counsel, and Medical Officers in order to achieve and ... the state of New York as needed. + Ensures compliance with applicable contractual requirements, and federal and state...+ Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of… more
- Fresenius Medical Center (Neenah, WI)
- …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 **MAINTENANCE/TECHNICAL:** + Maintain environmental… more
- Banner Health (WI)
- …assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state ... Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)...make needed corrections and ensure accurate coding, reimbursement, and compliance . 7. Provides mentoring for less experienced staff members… more
- Fresenius Medical Center (Fitchburg, WI)
- …nurse in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. ... policies, procedures and systems are incorporated into training, including compliance with ethical business practices. **PATIENT RELATED:** Education:Assist other… more