- Prime Therapeutics (Harrisburg, PA)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** Manages the ... coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership skills that ensure successful Part D pharmacy… more
- Gentiva (Bala Cynwyd, PA)
- …+ **Demonstrated ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid, JCAHO, ACHC)** We are seeking a ... + Demonstrated ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid, JCAHO, ACHC) + Knowledge and compassion… more
- UNC Health Care (Hendersonville, NC)
- …research encounters to the study, reviewing charges for research patients to ensure Medicare billing compliance , and create treatment plans in Beacon for ... management of care of patients participating in clinical trials, ensuring compliance with protocol procedures, assessments, reporting requirements, and management of… more
- RWJBarnabas Health (Oceanport, NJ)
- …and DRG assignment for adherence to Federal and State Regulations and Compliance Guidelines. + Critically analyzes each Medicare inpatient medical record ... Inpatient Coding Quality Officer III - ( Medicare ) RemoteReq #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services… more
- Providence (OR)
- **Description** **Quality Program Manager - Health Plan Medicare Advantage Stars** **_Remote_** **The Quality Program Manager - Health Plan Medicare Advantage ... interventions that result in improved Star ratings.** **The Health Plan Medicare Advantage Stars Quality Program Manager will:** + Develop and implement… more
- Humana (Lansing, MI)
- …service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which may include national clinical ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Humana (Concord, NH)
- …service should be authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources which may include national clinical ... of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- University of Rochester (Rochester, NY)
- …to authorizations, coordination of benefits, baby not on policy, Cobra entitlement, Medicare Lifetime Reserve days, and Medicare Advantage issues. This role ... adding newborns onto policy. + Determine the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits. + Notify… more
- Houston Methodist (Katy, TX)
- …Access Services, and Utilization Review as needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid ... position provides guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and terminating employment,… more
- Fallon Health (Springfield, MA)
- …in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more