- Molina Healthcare (Orlando, FL)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- The Cigna Group (St. Louis, MO)
- …will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide ... with all cross-functional areas of the organization + Understand and ensure compliance to CMS guidance and regulations + Influence account teams, clients, and… more
- HCA Healthcare (San Antonio, TX)
- …and delivery of quality interdisciplinary home health care services. Will ensure compliance to federal/state standards and clinical best practices. **What you will ... from Quality Review Specialist) to ensure the medical records reflect compliance with medical necessity, homebound status, visit utilization, and documentation of… more
- Gentiva (Stockbridge, GA)
- …developing associates and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory agencies. + ... new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining authorization and reauthorization as needed,… more
- Humana (Des Moines, IA)
- …The Senior Agency Management Professional supports data analysis related to compliance and commissions for Humana's external producers. The role involves handling ... provides support for handling and analyzing data that pertains to the compliance and commissions of Humana external producers. The Senior Agency Management… more
- Corewell Health (Grand Rapids, MI)
- …outcomes for members within the dual-eligible population. This role ensures compliance with state and federal regulations and fosters cross-functional collaboration ... LTSS. It also ensures that LTSS operations align with the integration of Medicare and Medicaid benefits under Michigan's HIDE SNP model, meeting CMS and MDHHS… more
- HCA Healthcare (Nashville, TN)
- …and delivery of quality interdisciplinary home health care services. Will ensure compliance to federal/state standards and clinical best practices. What you will do ... from Quality Review Specialist) to ensure the medical records reflect compliance with medical necessity, homebound status, visit utilization, and documentation of… more
- Nuvance Health (Danbury, CT)
- …State and Federal regulatory and reimbursement guidelines, maintains compliance while optimizing appropriate revenue opportunities 3.QA activities including ... performed by Outpatient Coding team for accuracy. 4.Work closely with the Compliance department on audits, reporting, complaint coding issues etc. 5.Research CMS and… more
- CenterWell (Louisville, KY)
- …the organization in community and marketing events. + Develop and maintain compliance with the departmental and physician budgets. + Assess, develop and recommend ... strategies for compliance with regulatory requirements. + Develop and maintain an...**Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- Molina Healthcare (San Diego, CA)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more