- Aveanna Healthcare (Atlanta, GA)
- …compensation practices and policies, and make recommendations to improve compliance , efficiencies, and competitive advantage + Administer all compensation components ... system, oversight and approval of compensation changes, maintenance of minimum wage compliance and FLSA compliance related to compensation, execution of annual… more
- Community Health Systems (Antioch, TN)
- …This role facilitates accurate and timely submission of applications, maintains compliance with payer requirements, and updates provider records to ensure the ... submits applications for provider enrollment and re-credentialing with insurance companies, Medicare , Medicaid, and other payers. + Monitors and tracks enrollment… more
- Lumeris (NH)
- …of stay. All reviews are conducted in accordance with departmental and Medicare guidelines. Performs discharge planning and care coordination with inpatient case ... for the interpretation and evaluation of clinical data to ensure compliance with established criteria. + Reviews authorization requests for services according… more
- CVS Health (Hartford, CT)
- …**Guides departments in developing and maintaining policies that ensure compliance with all state and federal regulations.** **Ensures readiness and ... DSNP Program Managers and Community Development teams** **Partners with local Medicare leadership to ensure operational efficiency and optimal resource allocation… more
- Molina Healthcare (GA)
- …overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. **Knowledge/Skills/Abilities** ... plan for the Medicaid , CHIP, Marketplace, MMP and Medicare lines of business. * Works with staff and...* Oversees Enrollment and Contact Center Operations to ensure compliance with health plan requirements. Works collaboratively with Corporate… more
- NHS Management, LLC (Carthage, MO)
- …resolution and development of business office goals and objectives. + Strives for compliance with internal controls and state and federal regulations. + Ability to ... other business office related tasks, including but not limited to: + Medicaid, Medicare and/or secondary billing + Assist with evaluation and selection of all… more
- State of Georgia (Fulton County, GA)
- …Georgia Medicaid Program. + Demonstrates thorough knowledge of and insures compliance with departmental policies and procedures governing the Georgia Medicaid ... Program; state and federal laws and policies governing Medicare and Medicaid. + Applies appropriate regulations, policies, and procedures to accurately determine… more
- BrightSpring Health Services (Louisville, KY)
- …(RAC, ZPIC, etc) requests + Audits patients records for quality and compliance per applicable home health regulations for submission for pre-claim review process ... of Review Choice Demonstration + Audits patients records for quality and compliance per applicable home health requirements or for other projects per agency need… more
- CareFirst (Baltimore, MD)
- …Operations Supervisor supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid, and ACA markets. This role ensures operational ... compliance by supervising day-to-day activities, monitoring performance metrics, and...ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA, and state-specific regulations. Remain current on… more
- Memorial Sloan-Kettering Cancer Center (NY)
- …will be responsible for crafting budgets for various clinical studies, ensuring compliance with all relevant regulations and policies. Your expertise will serve as ... for faculty engaged in clinical research, guiding them on budgetary and Medicare Coverage Analysis (MCA) matters. Collaborating with diverse teams across the… more