- Tufts Medicine (Boston, MA)
- …documentation while maximizing patient satisfaction. Works closely with risk management department on sever grievances involving litigation. Assures the organization ... remains compliant with the CMS regulations and Joint Commission Standards relating to the...Description** **Minimum Qualifications** **:** 1. Associate's degree in healthcare management . 2. Two (2) years of related experience in… more
- Intermountain Health (Murray, UT)
- …evaluation, and listing for heart transplantation in compliance with UNOS and CMS guidelines. + Participate in the management of mechanical circulatory ... director. + Ensure program compliance with all regulatory bodies, including UNOS, CMS , The Joint Commission, and state health departments. + Oversee program… more
- CareFirst (Baltimore, MD)
- …through coordination of analytical processes, investigation and interpretation of CMS risk score methodology, risk score calculation, enrollment, premiums, medical ... and maintain business process and technical workflow documents. + Understand CMS risk score methodology, including risk score calculation, financial risk receivable… more
- Nuvance Health (Danbury, CT)
- …accurate clinical information to all payers, while ensuring compliance with CMS requirements, guidelines, and standardized published criteria to support the medical ... admission and continued hospital stays. This role will require specialized system skills, best practice application of i? 1/2investigatingi? 1/2 payer practices,… more
- UPMC (Pittsburgh, PA)
- …and Accreditation is accountable to the Quality and Safety Director for the management of all regulatory compliance programs, including TJC, Department of Health and ... CMS regulations and standards. In addition, this individual will...compliance + Collaborate with patient safety officer and risk management department as needed + Assist in review of… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- Summary The Centers for Medicare and Medicaid Services ( CMS ) seeks candidates, including accountants and attorneys, to fill a vacant position on the Provider ... edits decisions; develops the administrative record; and timely handles case management and disposition activities. Supports the Board Chairperson's distribution of… more
- Access Dubuque (Dubuque, IA)
- Workforce Absence Management Payroll Coordinator **Sedgwick** 1 Positions ID: R69045 Posted On 12/19/2025 **Job Overview** By joining Sedgwick, you'll be part of ... Fortune Best Workplaces in Financial Services & Insurance Workforce Absence Management Payroll Coordinator **Our teams connect! We collaborate onsite and have… more
- UCLA Health (Los Angeles, CA)
- …across all Medicare Advantage products. This role is critical to improving CMS Star Ratings by enhancing member satisfaction, engagement, and retention throughout ... experience strategy for Medicare Advantage products + Drive improvements in CMS Star Ratings through initiatives focused on member satisfaction, engagement, and… more
- Access Dubuque (Dubuque, IA)
- …may delegate some duties to others within the unit. + Identifies and advises management of trends, problems, and issues as well as recommended course of action; ... informs management of new procedures and ideas for continuous process...Company** **Career Development** Our goal is to make Sedgwick CMS a place where great people can do great… more
- Trinity Health (West Springfield, MA)
- …Improvement Plan for the PACE Organization (PO) and ensure overall CMS regulatory compliance. The Director, Quality Improvement and Compliance, in collaboration ... and the Board of Directors. + Ensure compliance with CMS regulations. Has overall responsibility for the Medicare Part...and all subsequent follow up activities. + Analyze risk management data and quality data in order to identify… more