- Novant Health (Charlotte, NC)
- …and play a vital role in ensuring timely, accurate care assessments and claims management for our patients. In this full-time role, you will complete and schedule ... (MDS), coordinate insurance pre-authorizations, attend key interdisciplinary meetings, and support CMS claims audits, all while helping drive quality outcomes and… more
- Molina Healthcare (Tampa, FL)
- …average hold time are compliant with Centers for Medicare and Medicaid Services ( CMS ) regulations. * Ensures that adequate staffing coverage is present at all times ... for review. * Assures that activities and processes are compliant with CMS , National Committee of Quality Assurance (NCQA) guidelines, and Molina policies and… more
- Medical Express Ambulance Service (Skokie, IL)
- …ambulance services. This role provides strategic oversight and day-to-day management of billing and collections operations, ensuring timely, accurate, and ... + Oversee the end-to-end revenue cycle, including claims processing, denial management , account resolution, payment posting, coding, credentialing, and auditing. +… more
- Penn Medicine (Philadelphia, PA)
- …clinical programs, multiple clinical specialties, complex regulatory requirements, management of external partnerships/collaborations. **Summary:** + The Associate ... with Practice Leadership. The Associate Clinical Manager ensures compliance with TJC, CMS , and DOH requirements across all practice locations. The Associate Clinical… more
- Nuvance Health (Norwalk, CT)
- …such as but not limited to USP 797, USP 800, Joint Commission medication management , applicable state law, CMS code of participation and hospital/network policy ... regulations, specifically USP 797 and 800, Joint Commission medication management , applicable state law, drug laws, and CMS... management , applicable state law, drug laws, and CMS code of participation. c. Maintains compliance with all… more
- Houston Methodist (Houston, TX)
- …and CMS regulations, DNV requirements, and guidelines on case management , utilization review, and clinical documentation. + Provide ongoing education to ... position is responsible for teaching, consulting, and advising the case management department, clinical documentation specialists, medical staff and the hospital on… more
- CGI Technologies and Solutions, Inc. (Centennial, CO)
- …defining scalable, secure, and composable architectures that support personalized, content -driven digital experiences across channels, while ensuring alignment with ... performant . Define end-to-end digital platform architectures, integrating AEM with CMS , DAM, commerce, CRM, identity, analytics, and marketing ecosystems .… more
- OhioHealth (Columbus, OH)
- …Accounting or Finance. Hospital and/or healthcare industry experience. Understanding of the CMS prospective payment system and State of Ohio regulations. Minimum ... **We are more than a health system . We are a belief system .**...to use extensive interpersonal skills in communicating with all management levels at OhioHealth. * This role functions in… more
- Guidehouse (San Antonio, TX)
- …implementation, and ongoing optimization of security architectures for court case management platforms and their integration with other state and partner agency ... robust security architectures for cloud, hybrid, and on-premises court case management systems, ensuring compliance with federal and state regulations (CJIS, HIPAA,… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …and maintain timely and accurate information on all cases in CPR's case management system (Access database) used for on-going monitoring, reporting and ... but are not limited to: + CPRC/S membership + Healthcare Contracting and Management Team + Legal Department: + Medical Directors + Member Appeals Grievance Programs… more