- Evolent (Helena, MT)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Evolent (Helena, MT)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Evolent (Helena, MT)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Gentiva (Auburndale, MA)
- …a high-performing hospice program, ensuring excellent care delivery and regulatory compliance * Supervise, teach, evaluate, and develop nursing and clinical ... administrative workflows such as documentation of referrals, DME pickups, Medicare eligibility, insurance verifications, and patient benefit tracking * Coordinate… 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 procedures that integrate state, federal and national accreditation regulations to ensure compliance . The manager will oversee the training of the staff and work… more
- US Tech Solutions (Wichita, KS)
- …to obtain additional information. + Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines. + ... of Care cases across all lines of business (Commercial and Medicare ). + Independently coordinates the clinical resolution with internal/external clinician support… more
- Penn Medicine (Lancaster, PA)
- …associated with the procuring, compounding and storage of medications in compliance with department policies and procedures that provide optimal pharmaceutical care. ... to promote efficient operation of the pharmacy and regulatory compliance . + Assists with the clinical management of assigned...+ A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance… more
- Point32Health (Canton, MA)
- …contract reimbursement for approximately 30 different ancillary service lines for Medicare , Medicaid and Commercial product lines. The Director also identifies ... strategies designed to produce medical or administrative cost savings, or assure compliance with federal and state regulations, including but not limited to… more
- DiPasquale Moore (Kansas City, MO)
- …managing all claims related to health insurance and their liens, including Medicaid, Medicare , and ERISA. This role is crucial in ensuring that our clients' ... settlements. * Manage the lien resolution process for Medicaid, Medicare , and ERISA claims. * Ensure timely and accurate...and track the status of lien claims to ensure compliance with all regulations and deadlines. Negotiation and Reduction:… more
- Aveanna Healthcare (Worcester, MA)
- …regulatory standards, and Aveanna policies to ensure top-tier care and compliance . + Provide On-Call Leadership:Be a consistent, reliable resource for clinical ... or similar leadership role (preferred) + Deep understanding of state/federal compliance and private duty nursing operations + Strong communication, time management,… more