• Charge Integrity Coordinator

    Nuvance Health (Danbury, CT)
    …and its component operations, including billing, collections, charge capture, coding compliance , managed care contractual terms, Medicare and Medicaid ... requests in all systems, including CERNER MILLENIUM to maintain regulatory compliance and meet operational requirements. 7.Builds exploding codes in CERNER. Ensures… more
    Nuvance Health (09/19/25)
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  • Registered Nurse Clinical Risk Manager

    AdventHealth (Wesley Chapel, FL)
    …prevention of patient care-related grievances per established patient grievance protocol in compliance with the Centers for Medicare and Medicaid Services (CMS). ... investigates and processes internal event report system for assigned area in compliance with Florida Statute 395.0197. + Monitors, analyzes, and reports aggregated… more
    AdventHealth (09/19/25)
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  • Director, Security Operations

    Waystar (Atlanta, GA)
    …accounts, and service accounts. + Perform user access reviews required to meet compliance (SecurEnds). + Other duties as required **WHAT YOU'LL NEED** * Have a ... + Experience working in an environment with audit and regulatory compliance requirements + Experience training others + Experience writing technical documentation… more
    Waystar (09/19/25)
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  • Physician Advisor, Utilization Review/Management

    Sutter Health (Sacramento, CA)
    …best practices, level of care progression, denial management and compliance with governmental regulations and conditions of participation and commercial ... in the appropriate level of care with supporting documentation of regulatory compliance and accurate coding. The Physician Advisor (PA) conducts clinical reviews on… more
    Sutter Health (09/18/25)
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  • Patient Care Manager - Clinical Manager (RN)

    Gentiva (North Charleston, SC)
    …developing associates and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory ... state of residence and requested employment + Demonstrates knowledge and compliance with accepted hospice principles and practice, including industry standards,… more
    Gentiva (09/18/25)
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  • Youth Services Specialist I - Prairie Vista Youth…

    State of Colorado (Adams County, CO)
    …seeking and how did you accomplish it? 20 In order for our facilities to remain in compliance with State and Federal Laws, there may be times when we will need ... Emotional Intelligence. Requirement to adhere to the CDHS Code of Conduct, DYS Compliance Review Standards, and CDHS and DYS policies. Success will come through the… more
    State of Colorado (09/18/25)
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  • Physician Advisor

    HonorHealth (AZ)
    …resources. The PA further acts as a resource for the medical staff regarding federal and state utilization and quality regulations. As a CDI physician advisor, the ... indicated, advises case management to render letter of non-coverage in compliance with regulatory requirements. + Case Management Support: Supports case management… more
    HonorHealth (09/17/25)
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  • Senior Accountant

    Humana (Lincoln, NE)
    …ensures the integrity of accounting records for completeness, accuracy and compliance with accepted accounting policies and principles. + Provides financial support, ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/17/25)
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  • Area Business Specialist, Neuroscience (IA/NE/KS)…

    J&J Family of Companies (Omaha, NE)
    …and REMs. Educate entire staff on REMs set up, certification, program compliance and document requirements. Refer HCPs and staff to centralized access, ... verification, pre-authorization, billing, coding, claims, and appeals/grievances); REMs certification; Medicare and Medicaid rules and regulations; and state-specific clinical… more
    J&J Family of Companies (09/17/25)
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  • Provider Contracts Manager (Must reside…

    Molina Healthcare (GA)
    …with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal , state and local regulations. Negotiates ... meeting Molina's network adequacy standards. * Assesses contract language for compliance with Corporate standards and regulatory requirements and review revised… more
    Molina Healthcare (09/17/25)
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