- Humana (Indianapolis, IN)
- …bid process. This role includes competitive analysis, project management, Medicare Advantage plan design and implementation, and cross-functional leadership. ... bid process. This role includes competitive analysis, project management, Medicare Advantage plan design & implementation, and cross-functional leadership. Strategic… more
- Athena Health Care Systems (Marlborough, MA)
- …in assessing and documenting residents' needs, developing care plans, and ensuring compliance with regulations. Experience & Education: + Must possess, as a minimum, ... policies and procedures and protects residents' individual health information. + Maintains Medicare meeting minutes per Medicare program agreement. + Issues and… more
- Heritage Ministries (Conneautville, PA)
- …pre-admission notes and face sheet, and the primary insurance coverage (other than Medicare ). Verifies the Medicare benefit and coverage as well as benefits ... insurances. (Admissions will obtain pre-authorization for primary insurances other than Medicare ). Obtains copies of the resident's insurance cards, POA or… more
- Penn Medicine (Plainsboro, NJ)
- …**Summary** : + Under supervision from the Director and/or the Clinical Manager of Admissions provide insurance verification and coordination for all commercial, ... Medicaid and Medicare cases across programs to facilitate patient access to...alerts Continues to update knowledge and skills to maintain compliance with all insurance regulations and requirements + Ability… more
- Carle Health (Peoria, IL)
- …and answering incoming calls from the nursing facilities Responsible for maintaining Medicare regulatory compliance with the delivery of the "Important Message" ... works under the direction of the Clinical Transition Specialist (RN Case Manager ) and/or Social Worker to establish appropriate discharge plans for patients such… more
- CenterWell (Lexington, KY)
- …the care team through daily huddles. + Helps Regional Medical Director and Clinic Manager in setting a tone of cooperation in practice by displaying a professional ... primary care "on-call" program of CenterWell as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your… more
- CenterWell (New Albany, IN)
- …the care team through daily huddles. + Helps Regional Medical Director and Clinic Manager in setting a tone of cooperation in practice by displaying a professional ... primary care "on-call" program of CenterWell as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your… more
- SSM Health (Fond Du Lac, WI)
- …Agnes Hospital **Worker Type:** Regular **Job Summary:** Coordinates regulatory compliance activities. Works collaboratively with leaders, clinicians and other staff ... meet regulatory requirements. Ensures implementation of an integrated regulatory compliance and accreditation program. **Job Responsibilities and Requirements:** PRIMARY… more
- Molina Healthcare (Dayton, OH)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- Nuvance Health (Danbury, CT)
- …State and Federal regulatory and reimbursement guidelines, maintains compliance while optimizing appropriate revenue opportunities 3.QA activities including ... performed by Outpatient Coding team for accuracy. 4.Work closely with the Compliance department on audits, reporting, complaint coding issues etc. 5.Research CMS and… more