- CVS Health (Indianapolis, IN)
- …an exciting opportunity to join it's CVS Health's leadership team as a Director , Pharmacy Benefit Management (PBM) Underwriting, Analysis and Strategy. In this role, ... and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business. + Conduct market… more
- Humana (Indianapolis, IN)
- …members in maintaining Medicaid eligibility + Collaborate with Medical Director /Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, holistic ... Scott, Harrison, or Floyd County **Preferred Qualifications** **Prior experience with Medicare & Medicaid recipients** + Previous experience with electronic case… more
- Guthrie (Cortland, NY)
- …clinical and financial information under the discretion of the Administrator and Director of Nursing. This will include, but not be limited to pre-admission ... illness and disability. + Preferred knowledge of MDS, PRI/Screen instruments, Medicare , and Medicaid. Essential Functions: Coordinates admissions of residents: +… more
- HCA Healthcare (San Antonio, TX)
- …of the organization and meets the requirements or regulations of JACHO, Medicare , Medicaid, and appropriate licensing or certified boards. The supervisor is ... a therapist in the specific discipline of the supervisor. 4. Ensures Compliance with the conditions of participation, requirements or regulations of the following:… more
- Atlantic Health System (Morristown, NJ)
- …safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in ... highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its...members. Offerings vary based on role level (Team Member, Director , Executive). Below is a general summary, with role-specific… more
- Bear Mountain Health Care (Worcester, MA)
- …Monitoring and auditing clinical records, ensuring accuracy & timeliness + Must be in compliance with MDS / Medicare protocols and policies. + Informing DON and ... Facility in Worcester, MA, is currently seeking applicants for an experienced MDS Director . Requirements: + Graduate of an accredited school of nursing with current… more
- City of New York (New York, NY)
- …Engagement Unit, Health and Hospitals, and Community-based Organizations. To ensure full compliance of these partnerships the Bureau of Equitable Health Systems is ... 65 or older, Blind and Disabled (ABD) Medicaid and Medicare Savings program (MSP); applying for Medicare ;...the job application or interview process, contact Sye-Eun Ahn, Director of the Office of Equal Employment Opportunity, at… more
- Sea Mar Community Health Centers (Federal Way, WA)
- …required are general computer skills, typing skills and a working knowledge of Medicare Compliance , OSHA and HIPAA. Responsibilities include: + Posting payments, ... ensuring accurate and timely processing of all third party insurance, Medicaid, Medicare , Private Pay, and special programs. This position will require that… more
- New York State Civil Service (Albany, NY)
- …clinical reviews, recommendations, and determinations in collaboration with the Medical Director 's office, maintaining compliance with all bureau, agency, ... (Clinical Quality Assurance Team Lead) will report directly to the Bureau Director . This position will implement standard operating procedures which will be the… more
- LA Care Health Plan (Los Angeles, CA)
- …for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, ... setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination requires extended review. Collaborates with… more