• Retirement Specialist

    University of Delaware (Newark, DE)
    …THE JOB: Under the general direction of the Human Resources Benefits Director , the Retirement Specialist is responsible for administering retirement plan counseling ... in the HRIS system, vendor enrollments, ACH payments and returns, and Medicare -related programs such as TEFRA/DEFRA. Coordinate and ensure the accuracy of benefits… more
    University of Delaware (09/02/25)
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  • MassHealth Regulatory Compliance & Audits…

    Commonwealth Care Alliance (Boston, MA)
    …will not be considered at this time._** Position Summary: Reporting to the Director , Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. ... and federal healthcare regulations, particularly MassHealth (Massachusetts Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations… more
    Commonwealth Care Alliance (09/01/25)
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  • Physical Therapist (PT)

    Signature Healthcare (Memphis, TN)
    …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... number of Signature centers are earning Five-Star ratings from the Centers for Medicare & Medicaid Services. We were also named one of Modern Healthcare's "Best… more
    Signature Healthcare (08/31/25)
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  • Registered Nurse (RN) - Case Manager - PRN

    Texas Health Resources (Arlington, TX)
    …for utilization management including but not limited to Joint Commission, TMF, TDI, Medicare , and Milliman Care Guidelines. 2. Applies knowledge of Medicare and ... and participates in professional organizations and seminars as deemed appropriate by director and/or manager including but not limited to management growth. 5% What… more
    Texas Health Resources (08/29/25)
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  • RN MDS Coordinator Join Our Team today!

    Bear Mountain Health Care (Worcester, MA)
    …Facility in Worcester, MA, is currently seeking applicants for an experienced MDS Director . Requirements: + Graduate of an accredited school of nursing with current ... + One year of Long-term care experience + Experience with Medicare /Medicaid reimbursement, MDS completion, clinical resources utilization, and/or case management is… more
    Bear Mountain Health Care (08/29/25)
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  • Outpatient Coding Auditor

    Nuvance Health (Danbury, CT)
    …audits, reporting, complaint coding issues etc. 5.Research CMS and NGS Medicare regulations, guidelines, bulletins, and other publications for impact to professional ... services.Monitor listservs such as CMS, Medicare , NGS, AAPC etc. and third-party payers for coding and billing guidelines and regulations, professional peer… more
    Nuvance Health (08/28/25)
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  • Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …plan. + Assists Case Manager with medication prior authorizations. + Provides Medicare Important Message to Medicare beneficiaries per CMS Conditions of ... MD to MD reviews. + Performs audit activities under the supervision of the Director of Case Management and Social Work Services. Ellis Medicine is committed to… more
    Ellis Medicine (08/28/25)
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  • RN Market Executive of Clinical Quality, Home…

    CenterWell (Olympia, WA)
    …AZ and NM. + Homecare Homebase (HCHB) experience + Experience with CMS/ Medicare regulations and accreditation standards + Knowledge of CMS PDGM billing requirements ... + Experience managing healthcare revenue. + Experience in Medicare home health **Preferred Qualifications:** + Previous experience in home-based care functioning in… more
    CenterWell (08/28/25)
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  • Finance Analytics - Manager

    CVS Health (Hartford, CT)
    …Finance and other support groups. This Manager will work simultaneously across the Medicare VBC continuum, assisting the current team with monthly duties managing an ... inventory of Medicare accruals exceeding a half Billion dollars annually. Providing...inventory. The Manager will assist the Senior Manager and Director by working alongside the VBC Financial Analytics team… more
    CVS Health (08/27/25)
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  • SE PACE Account Executive

    Fallon Health (Framingham, MA)
    …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:** ... Regularly reviews effectiveness of efforts against goals. Provides market intelligence to the Director , PACE Growth & Engagement so that adjustments can be made to… more
    Fallon Health (08/27/25)
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