- Wolters Kluwer (Madison, WI)
- …information and policy data sources (CMS, FDA, etc.) covering drug control/ compliance programs, covered programs ( Medicare /Medicaid) and other government ... drug-related policy and program information. * Have an in-depth understanding of drug classification systems, drug packaging attributes, drug clinical attributes, pricing and reimbursement data, and regulatory classifications-and how these data types are used… more
- Humana (Madison, WI)
- …the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to ... and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+… more
- Humana (Madison, WI)
- …determining objectives and approaches to assignments. This role is within the Medicare Finance organization. This role will be required to collaborate with various ... valuations that help inform financial strategy related to the Medicare Advantage line of business. **Use your skills to...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (Madison, WI)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- SSM Health (Fond Du Lac, WI)
- …Agnes Hospital **Worker Type:** Regular **Job Summary:** Coordinates regulatory compliance activities. Works collaboratively with leaders, clinicians and other staff ... meet regulatory requirements. Ensures implementation of an integrated regulatory compliance and accreditation program. **Job Responsibilities and Requirements:** PRIMARY… more
- Marshfield Clinic (Marshfield, WI)
- …adjustment strategy and related revenue management for Security Health Plan's Medicare , Affordable Care Act and Medicaid business. This individual provides ... for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of...must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or… more
- Molina Healthcare (Kenosha, WI)
- …providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina ... adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to… more
- Marshfield Clinic (Weston, WI)
- …months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training ... time of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services at time of hire. **Marshfield Clinic Health System… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …working cross functionally to ensure accomplishment of business objectives and compliance with all relevant policies and procedures. **Job Description** **Strategy & ... actions. + Reviews Government Pricing policy, SOP's and SOX compliance documents on an on-going basis and updates as...understanding of GPO/PBM/National and Regional Health Plan business models, Medicare Part D, Medicare Part B, 340B,… more
- CVS Health (Madison, WI)
- …CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... to appropriate departments and management. + Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations. +… more