- Healthfirst (NY)
- …and terminations. + Collaborate with internal teams (eg, sales, customer service, compliance ) to ensure seamless management of members. + Monitor ,report, and ... ensures core Enrollment and Billing activities are managed in compliance with State and CMS guidelines and to ensure...and Knowledge of NY lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP… more
- Molina Healthcare (Savannah, GA)
- …submissions to NCQA and regulatory bodies, ensuring accuracy and timeliness. ** Compliance & Quality Improvement** + Monitors key performance indicators (KPIs) and ... rehearsals. + Ensures survey readiness by maintaining documentation and evidence of compliance . **Consultation & Collaboration** + Serves as a strategic advisor to… 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
- Waystar (Lehi, UT)
- **ABOUT THIS POSITION** The Senior Manager , HRIS leads our Workday platform strategy and harnesses AI and analytics to deliver trusted data, intuitive dashboards, ... compensation). + Maintain comprehensive documentation, govern configurations, and ensure compliance with internal SOX controls and applicable privacy regulations. +… more
- Sanford Health (Hillsboro, ND)
- …such as water, utilities, generators, lighting, security, pest control, etc. The Manager of Facilities evaluates present and future needs for real estate, owned ... budget and finance, short and long range planning, legal and regulatory compliance . Responsible for the interviewing, hiring, discipline of employees and any other… more
- Emory Healthcare/Emory University (Duluth, GA)
- …authorization for services is obtained; + Maintains working knowledge of and compliance with commercial/ Medicare / Medicaid payor guidelines. + Assess patients ... programs + And more **Description** We're seeking a **Registry Care Manager ** responsible for coordinating clinically complex patients' care across a continuum;… more
- OhioHealth (Columbus, OH)
- …- in our careers and in our communities. **Job Description Summary:** The Manager , Quality & Risk Adjustment is responsible for the strategic coordination of quality ... Health efforts including but not limited to Clinically Integrated Network (CIN), Medicare Shared Savings Program, etc. This position will: * Support a high… more
- Highmark Health (Dover, DE)
- …+ One year in home clinical or case management experience + Certified Case Manager (CCM) + Licensed Bachelors Social Worker (LBSW) + Licensed Masters Social Worker ... health population + Experience working with developmental disabilities population + Medicare and Medicaid experience + Managed care experience **SKILLS** + Working… more
- Trinity Health (Columbus, OH)
- …+ Ensure compliance with federal, state, and accreditation standards (eg, Medicare COP, Hospice licensure, OSHA). + Maintain accurate and compliant clinical and ... Trinity Health At Home is seeking a skilled and mission-driven Business-Facilities Manager to oversee the business operations of one or more home care… more
- CVS Health (Chicago, IL)
- …models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... clinical tools and information/data. - Utilizes case management processes in compliance with regulatory and company policies and procedures. - Facilitates… more