- Whidbey General Hospital (Coupeville, WA)
- …is a health care professional with experience and background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge ... and appeal/denial management. The RN - Care Manager serves as the organizational consultant to providers and staff to optimize patient throughput and assure that the… more
- CenterWell (Savannah, GA)
- …to individual clinicians about patient terminations, in + collaboration with Compliance + Supporting clinicians with schedule templates, coverage, daily issues + ... consumer experiences **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to… more
- Commonwealth of Pennsylvania (PA)
- …detail-oriented Health Care Nurse Surveyor to join our team and evaluate the compliance of health care facilities with state and federal regulations. By conducting ... you will conduct health care surveys in various facilities to determine compliance with federal and state regulations. Your work will involve reviewing facility… more
- General Dynamics Information Technology (Fairfax, VA)
- …personal impact as a **Salesforce Enterprise Manager** supporting the Centers for Medicare and Medicaid Services (CMS) Federal Services System Support and Oversight ... acceptance testing, ensuring proper bandwidth utilization, timely ticket resolution and compliance + Ensure the clarity, accuracy, and efficiency of the program's… more
- Humana (Indianapolis, IN)
- …Adhere to established guidelines and procedures to ensure consistency and compliance . **Potential Duties** + Advocate for our agile development approach and ... with the organization's strategy and long-term goals. + Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that… more
- Sutter Health (Sacramento, CA)
- …developer for ambulatory regulatory programs required by the Centers for Medicare and Medicaid Services (CMS), including the Merit-based Incentive Payment System ... (MIPS) and Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO)...latest CMS regulatory rules and data reporting requirements, ensuring compliance with all updates and revisions. Transforms regulatory program… more
- Ellis Medicine (Schenectady, NY)
- …as well as, the high risk population, chronic medical problems, non- compliance issues, interdisciplinary and/or patient, family, requests + Participates in ... of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or discharge...+ Coordinates acute hospital to hospital transfers to ensure compliance with all the discharge planning regulations and transfer… more
- AdventHealth (Altamonte Springs, FL)
- …stakeholders, and with multiple outside consultants and experts. Acts as a consultant to leaders ensuring the Medicaid rate setting, payment, and reconciliation ... Care, DGME, IME, Psych, Rehab, 340B and more. Is an important internal consultant to CFOs and strategic executives, routinely helping find and implement solutions… more
- HonorHealth (AZ)
- …needs of patients and alternative levels of care. The PA acts as consultant to and resource for attending physicians regarding their decisions relative to ... indicated, advises case management to render letter of non-coverage in compliance with regulatory requirements. + Case Management Support: Supports case management… more
- J&J Family of Companies (Santa Clara, CA)
- …partnerships with internal cross-functional leaders (eg, Sales, Marketing, Medical Affairs, Legal, Compliance ). + Serve as a key point of escalation for complex ... functions to ensure alignment on field reimbursement strategy and execution. ** Consultant & Project Management** + Manage multiple global consultants and projects… more