• RN - Assistant Director of Nursing

    Elderwood (Grand Island, NY)
    …ADON (RN) shall assess residents, perform audit measures and follow state, local and federal regulations and best practices within his or her scope of practice. + ... Act requirements, facility philosophy, and operational policies while maintaining compliance with other government agency laws and regulations. + Communicates… more
    Elderwood (09/19/25)
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  • Medication Therapy Management Specialist - Remote

    Prime Therapeutics (Lansing, MI)
    …specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM ... operations (eg workflow processes and case management) + Government programs ( Medicare ) knowledge **Preferred Qualifications** + Contact Center experience + Pharmacy… more
    Prime Therapeutics (09/17/25)
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  • Field Reimbursement Manager

    Adecco US, Inc. (Irving, TX)
    …trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay ... readiness and adoption. 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights… more
    Adecco US, Inc. (09/13/25)
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  • Medical Case Manager - (Remote) PA License

    Highmark Health (Harrisburg, PA)
    …and 3 years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. OR + Bachelor's degree in Social Work with five years' experience ... in Acute or Managed Care/ experience with Medicaid or Medicare populations **Preferred** + Experience working with high-risk pregnant...includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well… more
    Highmark Health (09/13/25)
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  • Community Engagement Specialist

    Highmark Health (Charleston, WV)
    …organizations and leaders. + Build an understanding of SDOH, Managed Care issues, Medicare , Medicaid, Dual Special Needs and delivery of those services to the ... regularly to learn of community needs. + Collaborate with Medicare Sales team to identify enrollment opportunities. + Other...includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well… more
    Highmark Health (09/13/25)
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  • Broker Relationship Manager (CO)

    Humana (Denver, CO)
    …put health first** Are you passionate about contributing to the well-being of the Medicare population? Would you like to play an integral and strategic part in the ... Qualifications** + 2+ years of sales experience in the Medicare industry + Prior experience with public speaking and...Interagency Language Rating (ILR) test as provided by the Federal Government. **Work at Home Information** To ensure Work… more
    Humana (09/09/25)
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  • Care Coach (Transition/Custodial Prevention)

    Humana (Burlington, IA)
    …related field. + Two (2) years of prior experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), ... experience. + Experience working with a Waiver Program. + Experience with Medicare & Medicaid recipients. + Experience working with complex health population. +… more
    Humana (09/08/25)
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  • Reimbursement Analyst (CCS or CPC) Coding…

    Mount Sinai Health System (New York, NY)
    …outpatient charges in accordance with established fee schedules and ensures compliance with Medicare and other insurance carrier guidelines. **Qualifications** ... systems to capture all inpatient and outpatient charges. Monitors managed care, commercial and federal contracts to assure the recovery of all inpatient and… more
    Mount Sinai Health System (09/06/25)
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  • Regulatory Analyst

    Healthfirst (NY)
    …Responsibilities:** + Performs first level review of all marketing materials to ensure compliance with State and Federal guidelines. + Prepares and submits ... been responded to. + Provides support to all internal stakeholders during the annual Medicare Go to Market project in preparation for the Medicare Annual… more
    Healthfirst (08/21/25)
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  • Clinical Revenue Auditor-CDM Patient Financial…

    Mount Sinai Health System (New York, NY)
    …payment. This position plays a key role in ensuring the financial health and compliance of the organization and bridges the gap between clinical care and medical ... requires a unique blend of clinical expertise and financial acumen to ensure compliance with healthcare regulations and collaborate with staff to resolve issues and… more
    Mount Sinai Health System (09/24/25)
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