- Humana (Indianapolis, IN)
- …Dual Eligible Special Needs Plans (DSNP), which serve members who qualify for both Medicare and Medicaid. They will lead the state Medicaid executive team and report ... with federal and state laws and programmatic requirements, including fraud , waste, and abuse; make decisions in an ethical...new ideas and initiatives from across the Medicaid and healthcare industry + Effectively support the growth of associates… more
- Covenant Health Inc. (Knoxville, TN)
- …F ive (5) years' experience in health care. Good working knowledge of healthcare billing, Medicare /Medicaid billing guidelines, and other Third Party Payor rules ... Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and… more
- UnityPoint Health (Cedar Rapids, IA)
- …and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any ... and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any… more
- UnityPoint Health (Cedar Rapids, IA)
- …hospital and department compliance for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any questions ... and department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse. Brings any… more
- Centene Corporation (Austin, TX)
- …overseeing all enterprise-wide sales investigations, with a primary focus on Medicare sales. Leads a high-performing investigation team responsible for examining ... compliance expectations. + Direct investigations into potential sales misconduct, fraud , misrepresentation, or non-compliant practices; oversee root cause analyses… more
- LEES MARKETPLACE (North Salt Lake, UT)
- …are up to date on all mandatory training; including but not limited to; Medicare Fraud Waste and Abuse Training, HIPAA Training, and Federal Combat ... environment where pharmacists work together and partner with local healthcare providers to solve challenges, share innovative ideas, and...on all mandatory training; including but not limited to; Medicare Fraud Waste and Abuse Training, HIPAA… more
- Henry Ford Health System (Troy, MI)
- …deletions of codes, use of modifiers, and revenue codes to be compliant with Medicare rules and regulations, the Medicare Billing Manual, the American Medical ... Manual (BAM) policies with correct codes ensuring that all Medicare covered codes are found on the BAM, new...coding questions related to claims, configuration, benefits, new technology, fraud , compliance, and any other issue. Aside from committee… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance, and billing practices. * Proficiency in Excel and ... are looking for dedicated and motivated individuals who share our vision of transforming healthcare . As a Blue Cross associate, you are joining a culture that is… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …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
- Executive Office for US Attorneys and the Office of the US… (Fresno, CA)
- …Affirmative Civil Enforcement: Responsibilities include enforcement investigations and litigation involving healthcare fraud , procurement fraud , grant ... the National Environmental Policy Act and other environmental statutes; Social Security, Medicare , and other federal programs; and "Bivens" civil rights actions. The… more