- 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
- Robert Half Finance & Accounting (Goshen, IN)
- …reporting. * Provide financial guidance and support for long-term care operations, including Medicare and Medicaid compliance . * Analyze and monitor budgets to ... reports for the finance committee and other stakeholders. * Ensure compliance with all applicable healthcare regulations and financial standards. Requirements *… more
- Penn Medicine (Philadelphia, PA)
- …letters for third party denials where appropriate * Apply the 2 midnight rule to Medicare reviews * Maintain compliance with Medicare rules as it applies ... medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, and appropriate physician… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health… more
- The Joint Commission (Oakbrook Terrace, IL)
- …from the field, analysis of periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of- compliance reports. + ... inductive reasoning skills to determine a health care organization's degree of compliance with applicable standards and functionality of care delivery systems. Field… more
- Gentiva (Mobile, AL)
- …role is responsible for ensuring the appropriate delivery of hospice services, compliance with Medicare Hospice Benefit Conditions of Participation, state ... Maintain compliance with federal, state, and local regulations, including Medicare and state survey requirements + Participate in orientation, training, and… more
- BAYADA Home Health Care (Exton, PA)
- …+ Provide direct supervision and support to field clinical staff + Ensure compliance with Medicare Conditions of Participation (CoPs), state regulations, and ... Therapist or Registered Nurse** to fill the position of **Rehab/Clinical Manager** in our Medicare -certified home health office in **Exton, PA** . Do you want to be… more
- UCLA Health (Los Angeles, CA)
- …identifying strengths, weaknesses, opportunities, and risks. + Monitor and ensure compliance with Medicare /Medi-Cal cost reporting rules and regulations, while ... operational effectiveness of UC Hospitals. Elevate your expertise in Medicare and Medi-Cal reimbursement while making a meaningful impact...reimbursement while making a meaningful impact on policy and compliance . You can do all this and more at… more
- CVS Health (St. Louis Park, MN)
- …you will lead the market-wide strategy, performance improvement, and execution of the Medicare Stars quality program for Allina Health | Aetna Medicare ... (HEDIS, Clinical Operations, Network, Pharmacy, Product, Member Experience, Data/Analytics, Compliance ) to implement evidence-based interventions. + Partner with external… more
- Humana (San Juan, PR)
- …represents Humana by addressing incoming telephone, digital, or written inquiries from Medicare members. The Call Center Representative 2 strives to provide the ... applying to other Humana opportunities outside of Individual or Group Medicare . **Required Qualifications** + **Must** **currently** **reside in Puerto Rico.** +… more