- 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
- ChenMed (Lakeland, FL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable center and market leadership to ensure compliance with guidelines along with participating in risk and quality management programs,… more
- Dignity Health (Las Vegas, NV)
- …training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. ... health care resource management; team and patient education regarding CCS/ Medicare /Medi-Cal/SSI + Performance & Outcomes Management: Understanding of Federal/State/Local… more
- UnityPoint Health (Grinnell, IA)
- …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 . + This position may be assigned a specific… more
- UnityPoint Health (Cedar Rapids, IA)
- …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 . Qualifications + Must be HT(ASCP) certified or eligible… more
- Henry Ford Health System (Detroit, MI)
- …that plays a central role in ensuring accurate net revenue reporting, compliance with complex payer regulations, and optimization of financial performance. Building ... net revenue impacts and forecasts to inform systemwide financial planning. Regulatory Compliance & Audit Oversight + Plan and coordinate third-party audits and… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …promotes quality healthcare delivery, manages healthcare costs, and ensures compliance with regulatory and accreditation requirements. This position is responsible ... Oversee Utilization Management to ensure alignment with organizational goals and compliance with regulations. + Develop, implement, and monitor strategies to manage… more
- AdventHealth (Orlando, FL)
- …responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Social Services implementation ... Management Manager is responsible for department engagement, customer experience, compliance of regulatory standards, and employee evaluations. The Care Management… more
- ATI (Dallas, TX)
- …matters, and will play a critical role in coordinating litigation, compliance , and technology initiatives across the Legal Department. Key Responsibilities ... settlement authority and support approvals process. + Oversee reporting obligations to Medicare , including managing account updates and access to the CMS Mandatory… more
- National Health Care Associates (Naugatuck, CT)
- …services provided. You will ensure the highest level of revenue integrity and compliance to all state and federal regulations for MDS completion and coding ... conventions. **Key Responsibilities:** + Lead and oversee the MDS program, ensuring compliance and accuracy in assessments + Determine Patient Driven Payment Method… more