- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …Access, or payer experience + Thorough understanding and knowledge of US healthcare economics and the drivers of pharmaceutical demand, including pricing and ... value chain and its business processes + Extensive experience in healthcare contracting and in-depth understanding of GPO/PBM/National and Regional Health Plan… more
- Baylor Scott & White Health (Dallas, TX)
- …individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core ... and accreditation standards, such as the Joint Commission, Centers for Medicare and Medicaid (CMS), National Committee for Quality Assurance (NCQA), Health… more
- Philips (Malvern, PA)
- …on issues facing sales, services, billing and reimbursement, and interactions with healthcare providers and professionals. Also, you will lead and be responsible for ... the seven elements of an effective compliance program to detect and prevent fraud , waste and abuse. **Your role:** + Develop, implement, and maintain policies and… more
- State of Minnesota (Vadnais Heights, MN)
- …across DCT. You will be responsible for all DCT Utilization Management, Medicare /Medicaid Compliance with CMS guidelines, and will lead, administer, direct, and ... LeadtheimplementationofDCT's Utilization Management strategicquality planconsistentwiththepriorities, regulatory requirements, patient safety, healthcare quality best practices, and budget principles of the… more
- Centene Corporation (Tallahassee, FL)
- …outcomes. + Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data. + Support execution of large-scale ... economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience.… more
- UnityPoint Health (Anamosa, IA)
- …and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in...+ Is aware of hospital and department compliance regarding fraud , waste and abuse. Brings any questions or concerns… more
- UnityPoint Health (Anamosa, IA)
- …and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in.... Is aware of hospital and department compliance regarding fraud , waste and abuse. Brings any questions or concerns… more
- State of Colorado (Denver, CO)
- …CBI name check and fingerprint check, ICON Colorado court database, Medicare fraud database, Reference Checks, Professional License verification (licensure ... expiration timelines and tracking documentation for regulatory compliance, including Medicare /Medicaid requirements. + Assists with procurement processes, coordinates with… more
- Texas Health Resources (Arlington, TX)
- …and Integration Monitor regulatory updates and evolving best practices in healthcare compliance. Integrate new guidelines into auditing processes and educate ... stakeholders on emerging expectations. Participate in external regulatory audits, including Medicare , OIG, and non- Medicare denial reviews. Provide expert… more
- UnityPoint Health (Des Moines, IA)
- …and department compliance requirements for federally funded healthcare programs (eg, Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in...to bill for government payers (ie, not on the Medicaid/ Medicare exclusion list.) . Document services accurately and timely… more