- LA Care Health Plan (Los Angeles, CA)
- …and adherence to LA Care's Policies & Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services ... and grievance reporting to regulatory agencies, internal Regulatory Affairs and Compliance Department, internal Quality Oversight Committee, etc. + Collaborates with… more
- Cabinet Peaks Medical Center (Libby, MT)
- …Access Hospital Conditions of Participation in accordance with The Center for Medicare Services, CMS. They oversee planning and management for the continuum of ... directly to the Chief Nursing Officer. The RN House Manager will ensure compliance with nursing policies, procedures, and programs. This role will also provide… more
- Penn Medicine (Gap, PA)
- …or heath information management team with in the established time frames. + Compliance Regulatory + Completes documentation for compliance and regulatory needs ... office setting equipment. + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance programs, ie not excluded… more
- University of Delaware (Newark, DE)
- …of independent judgment to coordinate, plan, and execute employee retirements in compliance with University and State of Delaware policies. The Retirement Specialist ... in the HRIS system, vendor enrollments, ACH payments and returns, and Medicare -related programs such as TEFRA/DEFRA. Coordinate and ensure the accuracy of benefits… more
- Gilead Sciences, Inc. (Foster City, CA)
- …managing Gilead's day-to-day administration and processing of all Managed Care Commercial/ Medicare Part D contract payments, in support of the contract development ... subject matter expert to ensure proper data validation, verification of contract compliance , rebate processing, and payment analysis to protect Gilead from revenue… more
- HonorHealth (AZ)
- …appropriate for billing, internal and external reporting, research, and regulatory compliance . Codes complex accounts which requires advanced expertise in coding ... documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical… more
- UnityPoint Health (West 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
- Molina Healthcare (Cincinnati, OH)
- …oversight of processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has ... decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise revenue, and enabling the… more
- WellSense (Manchester, NH)
- …health insurance company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as ... and community/ State agencies to increase patient knowledge, motivation, and compliance with treatment through targeted interventions that address the member's… more
- Trinity Health (Schenectady, NY)
- …(QRP) processes for the inpatient rehabilitation units. **Responsibilities:** + Assures compliance with all State and Federal requirements related to and oversees ... capture of documented conditions. + Tracks and reports regularly on 60% rule compliance . + Collaborates with interdisciplinary members of the team. + Assists with… more