- Aveanna Healthcare (Brookfield, WI)
- …of care and performs home visits as needed. * Ensures client compliance with federal/state regulations through policy and procedure administration to staff. * ... maintain active CPR per agency policy. Preferred: * Bachelor's degree preferred * Medicare Skilled Nursing experience and a basic understanding of OASIS * 3+ years… more
- Marshfield Clinic (Marshfield, WI)
- …Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG ( Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related ... 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
- Evolent (Madison, WI)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Humana (Madison, WI)
- …partnerships across internal teams and external vendors, and ensure compliance with CMS, Medicaid, and Pharmacy marketing regulations. **Key Responsibilities** ... capabilities + Ensure organizational alignment on campaign approaches and compliance with CMS, Medicaid, and Pharmacy marketing standards **Operational Excellence… more
- Humana (Madison, WI)
- …efficiency. Ensure robust database security, backup, recovery, and regulatory compliance in alignment with Humana's standards. Monitor database performance, ... Terraform. Familiarity with cloud security, access management, and regulatory compliance best practices. Excellent communication and documentation skills. Is eager… more
- Humana (Madison, WI)
- …value while balancing expense and business requirements, including regulatory compliance . Begins to influence department's strategy. Makes decisions on moderately ... Responsible for overseeing vendor governance for assigned vendors, ensuring compliance with organizational policies, contractual obligations, and performance standards… more
- Humana (Madison, WI)
- …through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to ... the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards. Champion transparency, accountability,… more
- Humana (Madison, WI)
- …enhance system reliability, and reduce operational overhead-all while ensuring compliance with healthcare regulations (eg, HIPAA, PHI). This individual will ... and implementation of new operational features and functions around Cloud compliance , metrics/reporting and cost optimization + Provide senior level expertise on… more
- Humana (Madison, WI)
- …on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. ... and Long-Term Services and Supports (LTSS) requirements, advising stakeholders on compliance , and facilitating NCQA LTSS file universe preparation and LTSS file… more
- Humana (Madison, WI)
- …renewal strategies aligned with Humana's technology roadmap, budget, and compliance requirements. + Establish governance frameworks for software renewals, including ... renewals. + Negotiate with suppliers to secure favorable terms, pricing, and compliance . + Maintain a centralized renewal calendar and proactively manage upcoming… more