- University of Utah Health (Murray, UT)
- …collaborate cross-functionally with clinical, coding, and IT teams to ensure compliance , optimize risk adjustment revenue, and help drive provider engagement ... and prospective risk adjustment analytics to drive revenue optimization and compliance . + Monitors risk adjustment metrics, trends, and anomalies across various… more
- State of Colorado (Pueblo, CO)
- …with clinical direction of nursing staff, QA/PI activities and to ensure compliance in all areas, and interdisciplinary collaboration. This position is accountable ... + Ensure all nursing assignments and duties are completed and in compliance with CMHIP policies and psychiatric and medical nursing standards, licensure requirements… more
- Somatus (Mclean, VA)
- …guidance and oversight to all lines of business including Commercial, Medicaid, Medicare , and Special Need Plans (SNPs). The Director, Quality will work closely ... Audit Risk and the Regulatory and Accreditation Team to ensure compliance with audits, complaints/grievances, and adherence to contractual obligations and Service… more
- MedKoder (Mandeville, LA)
- …Manager provides leadership to a team of auditors and educators, fostering growth, compliance , and quality in client engagements. This position also serves as a ... + Provide ongoing education to team and clients on coding updates, compliance issues, and best practices. + Address individual errors through targeted coaching.… more
- Sharp HealthCare (San Diego, CA)
- …developing the Benefits Administration team across multiple lines of business ( Medicare Commercial, Government, etc.) to ensure benefit plans are designed ... to ensure Benefit Administrator education is sufficient to meet benefit compliance and establish quality and productivity standards to be reported monthly.Develop… more
- UTMB Health (Galveston, TX)
- …agreements to ensure favorable reimbursement, alignment with organizational goals, and compliance with federal and state regulations. This role will oversee payer ... commercial and government payers, including HMOs, PPOs, ACOs, and Medicaid/ Medicare Advantage plans. * Analyze reimbursement methodologies and contract performance… more
- Point32Health (Canton, MA)
- …not limited to Dental, Vision, Durable Medical, Transportation, Hearing, and other Medicare supplemental benefits. The Manager of Vendor Oversight is responsible for ... the contractual performance and maintenance of the vendor to ensure compliance , performance, and accurate payment. Builds relationships with internal vendor business… more
- AdventHealth (Calhoun, GA)
- …is responsible for customer satisfaction, financial management, regulatory compliance , Human Resource issues, employee competency, Performance Improvement, ... persons not in attendance have access to review meeting minutes. + Regulatory Compliance + Complies with TJC (The Joint Commission) and HFAP (Healthcare Facility… more
- UnityPoint Health (Iowa City, IA)
- …work site compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... available equipment to maintain safety at work site. Regulatory Compliance * Provide documentation of rounds and all other...concerns regarding compliance to the immediate attention of hospital administrative staff.… more
- Gentiva (Yuma, AZ)
- …on-going continual improvements to policies, procedures, and documentation + Maintains compliance with federal and state regulations + Performs other related duties ... assigned + Consistently promotes the company's core values + Completes required Compliance annual training Essential Functions of Position + Directs and coordinates… more