- Atlantic Health System (Morristown, NJ)
- …all Annual Performance Evaluations, discipline as needed and work along side the manager to manage staffing, budgets etc. Required: + Graduate of an accredited ... highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its...& Auto, Identity Theft and Legal Insurance Note: In Compliance with the NJ Pay Transparency Act (effective Sunday,… more
- Waystar (Louisville, KY)
- …closely with User Experience team and Technology teams. The Sr. Product Manager will coordinate with key stakeholders in sales, marketing, design, development, and ... industry standards and staying up-to-date on industry changes and compliance issues + Gathering inspiration and ideas by visiting...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Conduent (Hamilton, NJ)
- …performance through technology-enabled services and platforms. Our solutions support Medicaid, Medicare , and other public health initiatives with a focus on program ... We are seeking a highly skilled and experienced Account Manager to join our team. This role is pivotal...At least seven years of experience in account management, compliance management, and Eligibility and Enrollment. + **Industry Knowledge:**… more
- Sutter Health (San Francisco, CA)
- …**CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + CCM - Certified Case Manager (certification may be required by entity and time to acquire may be ... in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Title 22, CHA Consent Manual,… more
- Centers Plan for Healthy Living (New York, NY)
- …need for healthy living. JOB SUMMARY : The Licensed Benefits Advisor- Medicare Sales, Maintains relationships, services our existing customers and secures new ... and performing all required tasks assigned by the Sales Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Molina Healthcare (GA)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Network staff ... contracting, provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the… more
- Virtua Health (Pennsauken, NJ)
- …Summary:Responsible for application of appropriate medical necessity tools to maintain compliance and achieve cost effective and positive patient outcomes.Acts as a ... Six Sigma committee, department and/or divisional teams and community activities. Compliance * Understands and applies applicable federal and state requirement.*… more
- Centene Corporation (Indianapolis, IN)
- …are met, and validate that clinical pharmacy programs meet applicable regulatory and compliance standards, such as Medicare Star ratings, NCQA HEDIS measures, ... clinical quality assurance programs, formulary management, drug utilization review, compliance and/or education. + Coordinate clinical efforts with other department… more
- Virtua Health (Pennsauken, NJ)
- …Six Sigma committee, department and/or divisional teams and community activities. Compliance * Understands and applies applicable federal and state requirement.* ... Identify and reports compliance issues as appropriate.Position Qualifications Required / Experience Required:Required: Must be RN or Masters prepared Licensed Social… more
- Virtua Health (Mount Holly, NJ)
- …Six Sigma committee, department and/or divisional teams and community activities.* Compliance - understands and applies applicable federal and state requirement. ... Identify and reports compliance issues as appropriate. Position Qualifications Required / Experience...years experience as Clinical Social Worker. Basic understanding of Medicare , Medicaid and managed care. Discharge planning or home… more