- Gentiva (Milwaukee, WI)
- …+ Direct the day-to-day operations of the home health branch, ensuring compliance with all applicable federal, state, and accreditation standards (CMS, Medicare ... role. + Strong knowledge of CMS regulations and home health compliance requirements. + Proven leadership, communication, and problem-solving skills. **Preferred… more
- Carle Health (West Peoria, IL)
- …department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... concerns regarding compliance to the immediate attention of hospital administrative staff....action on concerns reported by department staff related to compliance . Responsibilities + Actively listens to presenting issues, uses… more
- New York State Civil Service (New York, NY)
- …office leadership to coordinate training efforts to ensure employees remain in compliance with regulatory requirements. The Training Specialist 2 will also assist ... DSATs by reviewing evaluation reports.* Provide training and establish/maintain instructor compliance in required trainings (PROMOTE & CPR/FA/AED).* Work with ITS… more
- CareFirst (Baltimore, MD)
- …data to evaluate implications across various business lines, while ensuring compliance with company policies and procedures, and coordinating with the Payment ... amendments, and participate in internal workgroups and committees, ensuring compliance and advising on business strategies. **ESSENTIAL FUNCTIONS:** **Contract… more
- Cardinal Health (Salt Lake City, UT)
- …initiatives to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage ... for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends in denials and… more
- Robert Half Accountemps (Cincinnati, OH)
- …position, you will play a critical role in ensuring the accuracy and compliance of outpatient medical coding processes. This role is ideal for professionals with ... accordance with facility-specific guidelines. * Conduct medical necessity checks for Medicare and other payers based on established payment regulations. * Maintain… more
- Molina Healthcare (GA)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Network staff ... contracting, provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the… more
- Whidbey General Hospital (Coupeville, WA)
- …requirements to maintain operations and reimbursement including Medicare /Medicaid requirements, JCAHO accreditation, Rural Health Clinic standards/certification. ... limited to the Health Insurance Portability and Accountability Act (HIPAA). COMPLIANCE WhidbeyHealth is committed to providing quality, cost-effective health care in… more
- AdventHealth (Altamonte Springs, FL)
- …of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well as rules and regulations of all applicable local, ... and trends from the quality audits to the HIM/Coding leadership + Reports any compliance and/or risk issues to the compliance department. Provides suggestions on… more
- Humana (Juneau, AK)
- …of matters related to PBM and pharmacy services, including regulatory compliance ; contract drafting, negotiation, and management; and risk management. This position ... benefit plans. + Provide legal guidance on federal and state regulatory compliance . + Advise on risk exposure, mitigation strategies, and legal implications of… more