• System CDI Quality Team Leader Educator

    AdventHealth (Altamonte Springs, FL)
    …allied health practitioners, nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates ... with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains appropriate and quality physician… more
    AdventHealth (08/07/25)
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  • Cardiac Cath Lab Auditor

    AdventHealth (Tampa, FL)
    …CPT coding, and national coverage decisions in conjunction with medical charts to ensure compliance with Medicare , Medicaid and other third party payers as well ... and corresponding charges for appropriateness. Provide recommendations to ensure compliance ; improve procedures, revenue, cash flow, and strengthen controls.… more
    AdventHealth (09/26/25)
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  • Mental Health Coordinator

    UnityPoint Health (Des Moines, IA)
    …of agency compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... years of experiencing the onset of psychosis. The Peer Specialist on the team would help train clients experiencing...concerns regarding compliance to the immediate attention of the Corporate … more
    UnityPoint Health (09/13/25)
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  • Certified Medical Assistant

    UnityPoint Health (Clarence, IA)
    …department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... follow patients monitoring disease status. Schedule referrals for patients with specialist or outpatient as requested by the provider. Complete appropriate forms… more
    UnityPoint Health (09/19/25)
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  • Clinical Care Manager

    WellSense (Manchester, NH)
    …health insurance company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as ... and community/ State agencies to increase patient knowledge, motivation, and compliance with treatment through targeted interventions that address the member's… more
    WellSense (08/22/25)
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  • Provider Relations Rep - Hybrid - 1 day/EO week…

    Fallon Health (Worcester, MA)
    …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... within an assigned territory. Monitor provider business operations to ensure compliance with FCHP's documented standards, policy and procedures and government… more
    Fallon Health (08/08/25)
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  • CIRV Technologist -or- CIRV Radiology Technologist…

    Marshfield Clinic (Eau Claire, WI)
    …provided by the American Heart Association. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES) ... Heart Association within three months of hire. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES)… more
    Marshfield Clinic (08/13/25)
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  • Coding Data Quality Auditor

    CVS Health (Dover, DE)
    …to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... setting. + Sound knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify clinically active… more
    CVS Health (09/27/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Meridian, ID)
    …improvement activities. Responsible for overseeing delegated activities to ensure compliance with the National Committee for Quality Assurance (NCQA), Centers ... for Medicare and Medicaid Services (CMS), state Medicaid entity requirements...cost-effective member care. This position will support our Corporate Compliance business. The candidate must have an unrestricted LVN… more
    Molina Healthcare (09/20/25)
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  • Senior Care Options Nurse Case Manager - Hybrid…

    Fallon Health (Lowell, MA)
    …product regulatory requirements and Program policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
    Fallon Health (09/19/25)
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