- State of Colorado (Pueblo, CO)
- …Court order, Environment of Care manual, Centers for Medicare and Medicaid Services, Safety Data Sheets, Colorado State Personnel Procedure manual, Affirmative ... check and fingerprint check, ICON Colorado court database, Medicare fraud database, Reference Checks, Professional License verification (licensure requirements),… more
- Beth Israel Lahey Health (Westwood, MA)
- …members work to ensure information accuracy. (essential) 7. Monitors situations for fraud , waste, and abuse of Medicare/ Medicaid benefits and reinforces HIPAA ... and PHI protocols. (essential) 8. Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews. Direct… more
- Beth Israel Lahey Health (Boston, MA)
- …members work to ensure information accuracy. (essential) 9. Monitors situations for fraud , waste, and abuse of Medicare/ Medicaid benefits and reinforces HIPAA ... and PHI protocols. (essential) 10. Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews. Direct… more
- Somatus (Mclean, VA)
- …budget. + Payment Integrity Product Areas- Clinical Claim Review, Payment Analytics, Fraud Capture and Utilization Review Product Management + Oversees new product ... projects and meet tight deadlines + Comprehensive knowledge of Medicare, Medicaid , and commercial policies, processes, and procedures Travel Requirements: + Ability… more
- Amgen (Thousand Oaks, CA)
- …healthcare industry is a plus but not required, including counseling on: + Healthcare fraud and abuse matters + OIG compliance guidance and advisory opinions + DOJ ... settlements with pharmaceutical industry + Medicare/ Medicaid reimbursement and contracting + Congressional hearings and inquiries **What you can expect of us** As we… more
- Prime Healthcare (Dallas, TX)
- …to the Stark Law, the Antikickback Statute, the False Claims Act, and other Fraud , Waste and Abuse laws and regulations, along with the Medicare/ Medicaid ... Conditions of Participation, physician/physician group contracting, Medical Staff/peer review matters, hospital/facility licensing, telemedicine, Ambulatory Surgical Centers, and other healthcare operations5. Excellent contract negotiation and drafting… more
- New York State Civil Service (Rochester, NY)
- …administered by OTDA and other Executive agencies (eg, the Department of Health's Medicaid program, the Office of Children and Family Services' foster care and ... benefit program determinations. They may also preside over hearings addressing fraud , license revocation or suspension, violations, or health and safety… more
- LA Care Health Plan (Los Angeles, CA)
- …Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and other federal and state guidelines. Responsible for the ... Certified Internal Auditor (CIA) Certified Management Accountant (CMA) Certified Fraud Examiner (CFE) Physical Requirements Light Additional Information Salary Range… more
- New York State Civil Service (Albany, NY)
- …healthcare compliance, complex healthcare transactions, matters involving state and federal fraud and abuse compliance, general health law and regulatory issues, ... management and medical malpractice; health information technology; managed care; Medicare/ Medicaid Conditions of Participation (CoPs) and Conditions for Coverage… more
- Amgen (Chicago, IL)
- …counseling clients on complex legal and regulatory considerations including: + Healthcare fraud and abuse matters + FDA promotional regulations + OIG compliance ... and advisory opinions + DOJ settlements with pharmaceutical industry + Medicare/ Medicaid reimbursement and contracting + Proven superior legal skills, including… more