- Insight Global (Los Angeles, CA)
- …by medical groups and health plans contracted with LA Care, focusing on regulatory and contractual compliance across Medi-Cal, Medicare, Covered California, and ... Description Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems...Minimum 5 years in claims audits or processing within managed care (eg, Medi-Cal, Cal MediConnect). Skills: Strong analytical,… more
- Genesis Healthcare (Norfolk, VA)
- …of equipment, billing, and payroll within budgetary guidelines and business needs. Ensures compliance with all CAP/CLIA and other regulatory agency standards. 2. ... rehabilitation and quality assurance. 10. Establishes communication networks with Managed Care Caseworkers to assure approved appropriate care, effective… more
- BJC HealthCare (St. Louis, MO)
- …with health care team members to provide patient care. Ensures team compliance with departmental policies, regulatory requirements and professional standards; ... skills Full Time; beneift eligible position. Schedule is flexible. **Overview** **BJC HealthCare ** is one of the largest nonprofit health care organizations in the… more
- Prime Healthcare (Garden City, MI)
- …to deemed agencies, state law, and other regulations to assure compliance . Responsibilities KEY RESPONSIBILITIES: + Maintains complete knowledge of hospital policy, ... comply with administrative and medical staff policy, as well as regulatory expectations and standards. + Develops processes which facilitate credentialing,… more
- Catholic Health Services (Melville, NY)
- …Attends meetings as required and participates on committees as directed. Identifies managed care/ regulatory issues/ compliance contributing to denial activity ... Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named...Catholic Health Physician Advisor when appropriate. Reviews results from managed care payors and/or regulatory agencies determinations… more
- BJC HealthCare (St. Louis, MO)
- …+ Participates in activities that promote patient safety, quality and regulatory compliance . Participates in professional development. + Develops, implements, ... the Siteman Cancer Center to receive care for some urgent needs. These patients are managed by the Nurse Practitioners and cared for the the staff nurses and PCTs.… more
- AdventHealth (Maitland, FL)
- …providers. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms and provides appropriate ... guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental initiatives,… more
- Trinity Health (Ann Arbor, MI)
- …upon hire and ongoing as new systems and processes are created. Maintains compliance with HIPAA and other regulatory requirements throughout all activities. ... upon hire and ongoing as new systems and processes are created. Maintains compliance with HIPAA and other regulatory requirements throughout all activities.… more
- Houston Methodist (The Woodlands, TX)
- …compliance with ethical and legal business practices and accreditation/ regulatory /government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Provides direction to ... controls in a manner consistent with corporate policies, procedures, and compliance guidelines as well as generally accepted accounting principles, tax regulations,… more
- GEHA (Lee's Summit, MO)
- …benefit management, PBM oversight, pharmacy network strategies, clinical pharmacy programs, and regulatory compliance . Serving as a key member of the clinical ... ideal candidate is a PharmD with deep PBM and managed care experience, strong financial and regulatory ...and skill development in pharmacy design, development, and management. ** Regulatory Compliance and Quality Assurance** + Work… more