- 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
- Marshfield Clinic (Weston, WI)
- …Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training… more
- Gentiva (Wausau, WI)
- …ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure timely and ... health, or healthcare operations leadership + Strong understanding of hospice regulations, compliance , and Medicare conditions of participation + Proven ability… more
- CenterWell (Madison, WI)
- …innovation for chronically and temporarily homebound, polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director ... with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare regulations, value-based care principles, and best practices for complex care… more
- CenterWell (Madison, WI)
- …Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Marshfield Clinic (Marshfield, WI)
- …Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... rural health clinics within the Health System. This individual will assist with Medicare and Medicaid Cost Report coordination, Wage Index, S10, DSH and other… more
- Marshfield Clinic (Marshfield, WI)
- …Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened ... Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG ( Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related… more
- Highmark Health (Madison, WI)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
- Fresenius Medical Center (Slinger, WI)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... ongoing performance of other PCT's. + Collaborates with the Clinical Manager and Education Coordinator in driving organization quality standards through education… 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. ... ensure ongoing performance of other PCT's. + Collaborates with the Clinical Manager and Education Coordinator in driving FMS quality standards through education… more