- CVS Health (Hartford, CT)
- …alignment with both national and local market goals across Commercial, Medicaid, and Medicare lines of business. The role includes direct leadership of account leads ... of business.** **Operational Oversight** **Ensure network infrastructure supports adequacy, compliance , cost containment, and profitability goals. Drive operational excellence… more
- Modivcare (HI)
- …across all modes, ensuring achievement of KPIs (on-time rates, digital compliance , reroutes, etc.). + Drive accountability for "Perfect Trip" standards, root ... performance, and financial components. + Collaborate closely with Credentialing, Safety, Compliance , and Network Planning teams to mitigate risk and ensure… more
- Ochsner Health (Bay Saint Louis, MS)
- …of heath care systems and public programs such as those funded by Medicare , Medicaid, Medicare Advantage, and commercial insurance plans. + Strong interpersonal ... apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This...and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including… more
- UNC Health Care (Raleigh, NC)
- …liaison between other medical specialties and ancillary services. 3. Assists in achieving compliance with the Joint Commission, Centers for Medicare and Medicaid ... as management of resources in a cost-effective manner, and participates in compliance and quality performance improvement efforts to ensure that nutrition care is… more
- UnityPoint Health (Des Moines, IA)
- …department compliance requirements for federally funded healthcare programs (eg, Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... to bill for government payers (ie, not on the Medicaid/ Medicare exclusion list.) . Document services accurately and timely...concerns regarding compliance to the immediate attention of hospital administrative staff.… more
- UNC Health Care (Raleigh, NC)
- …liaison between other medical specialties and ancillary services. 3. Assists in achieving compliance with the Joint Commission, Centers for Medicare and Medicaid ... as management of resources in a cost-effective manner, and participates in compliance and quality performance improvement efforts to ensure that nutrition care is… more
- Ochsner Health (New Orleans, LA)
- …knowledge of managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage, and commercial insurance plans. + Proficiency in ... apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This...and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including… more
- Gentiva (Castle Rock, CO)
- …program staff to foster professional growth and ensure team success + Ensure compliance with state, federal, and Medicare /Medicaid regulations + Monitor and ... clinical and operational growth, manage team development, and ensure compliance with state and federal guidelines while delivering patient-centered, compassionate… more
- Penn Medicine (Lancaster, PA)
- …or heath information management team with in the established time frames. Compliance Regulatory + Completes documentation for compliance and regulatory needs ... office setting equipment.(Required) + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance programs, ie not… more
- The Cigna Group (Bloomfield, CT)
- …Management Advisor is responsible for supporting the Medicaid Encounter and Medicare prescription drug event (PDE) operational processes to ensure successful and ... analysis and remediation, in accordance with State guidance/regulations and Center for Medicare and Medicaid Services (CMS) and provide subject matter expertise to… more