- RWJBarnabas Health (West Orange, NJ)
- …to ensure alignment with system goals and financial impact Regulatory and Legal Compliance + Monitor and interpret federal and state regulatory developments ... and regulatory issues relating to payor relationships, third-party administrators, Medicare Advantage, and Medicaid Managed Care. This position requires at… more
- Atlantic Health System (Morristown, NJ)
- …and education of patients in accordance with established standards of care, compliance with The Joint Commission, state standards, and other regulatory requirements. ... education to patients and/or family members. + Maintains quality assurance and evaluates compliance with corporate policies and procedures and State and Federal … more
- CenterWell (Sarasota, FL)
- …of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team ... Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical… more
- Humana (Topeka, KS)
- …department and our vendor partners. Will support and promote consistent, compliance , and high-quality medical coding practices, with a strong focus collaboration ... aimed at identifying coding discrepancies, improving audit outcomes, and ensuring compliance with regulatory and contractual standards. + Designs and implements… more
- Aveanna Healthcare (Houston, TX)
- …a company that values Compassion, Integrity, Accountability, Trust, Innovation, Compliance , and Fun. Position Overview TheIntake Patient Care Representativeis ... patient concerns * Ensure work being performed meets internal and external compliance requirements * Maintain confidentiality of all information; adhere to all HIPAA… more
- Molina Healthcare (Buffalo, NY)
- …with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal , state and local regulations. Provider ... satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the… more
- Tufts Medicine (Lowell, MA)
- …working knowledge of all regulations;Has a working knowledge of the Medicare Conditions of Participation; and Assisting with individual caseload reviews or ... of what to report to the CEO or Chief Compliance Officer when concerns of corporate compliance ...procedures. + Practices confidentiality principles set by the agency and federal HIPAA/HITECH guidelines. + Participates in all mandatory… more
- East Boston Neighborhood Health Center (Revere, MA)
- …- Work with contract owners on negotiations and review + DPH + Assure compliance ED waivers and SEF requirements and waivers + Monitor for Serious Reportable Events ... role in updating: + Scope Needs Assessment + Assure compliance with the 19 program requirements + The Joint...health center during Lab and health center surveys + Medicare + Represent health center Administration during Pace surveys… more
- CenterWell (Daytona Beach, FL)
- …all standard operating procedures are adhered to within the center and all compliance required signage is visible in patient-facing areas and back-office to include ... audits, perform audits of center's clinical logs to ensure compliance and quality, manage MSDS and OSHA concerns, and...a global risk primary care environment + Familiarity with Medicare and Risk model + Experience managing a budget… more
- Avera (Sioux Falls, SD)
- …on education and/or improvement plans. Emergent reviews may be performed based on compliance and clinical need. This individual will be required to understand and ... communicate appropriate reimbursement methodologies for services audited and communicate with compliance as needed. This individual will follow all applicable … more