- Commonwealth Care Alliance (Boston, MA)
- …and enhance the risk adjustment data ecosystem. + Support audit readiness and regulatory compliance for Medicare and Medicaid risk adjustment programs. + ... + 5+ years of experience in data development or engineering within a healthcare or managed care environment. **Desired Experience (nice to have):** **Required… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …travel required **Scope of Responsibilities:** Oversight responsibility for the managed care department of the company. Responsible for training, development ... favorable contract outcomes and resolve disputes efficiently. + Monitor contract compliance , escalate disputes, and drive resolution of reimbursement issues. + Work… more
- KPH Healthcare Services, Inc. (Oneonta, NY)
- …compliant with the most current standards set by our accreditation bodies + Ensure compliance with all Noble policies and procedures at all times + Monitors all ... accordance with all state and federal guidelines + Ensures compliance with all rules and regulations pertaining to New...as required + Responsible for keeping current with state/federal regulatory changes and business trends within the industry +… more
- Bassett Healthcare (Delhi, NY)
- …all core functions (demographic and financial screening, insurance eligibility and verification, regulatory and compliance monitoring) of front desk services as ... responsibility through payment collection, cash handling, processing of insurance eligibility and managed care information. + Answer screen and triage phone calls in… more
- Robert Half (Chicago, IL)
- JOB REQUISITION Chicago - Risk & Compliance - Lender Due Diligence (Financial Services) Senior Consultant LOCATION CHICAGO ADDITIONAL LOCATION(S) JOB DESCRIPTION You ... Need You Protiviti is looking for a Risk & Compliance Senior Consultant to join our growing Lender Due...effective and efficient in a way that is risk-sensitive, regulatory compliant, well controlled, and enabled by leading technologies… more
- Kraus-Anderson (Minneapolis, MN)
- …has been transforming the American landscape. Founded in 1897 and privately owned and managed by the Engelsma family for more than 70 years, KA is consistently ... plans as required. + Coordinates project activities with activities of governmental regulatory or other governmental agencies. + Meets regularly with Finance to… 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
- 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