- Tufts Medicine (Lowell, MA)
- …**Minimum Qualifications** **:** 1. Bachelor's degree in Nursing (BSN). 2. Massachusetts RN Licensure. 3. Three (3) years of experience in community hospice clinical ... annual plan based on clinical, patient satisfaction and operational issues. 16. Reports Compliance concerns to the CEO or Chief Compliance Officer when… more
- Access Dubuque (Dubuque, IA)
- …department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... for the supervision of occupational therapist assistants and support staff in compliance with regulatory standards. **Why UnityPoint Health?** + **Commitment to our… more
- Logan Health (Kalispell, MT)
- …This position drives service excellence, operational performance, and regulatory compliance while fostering a culture rooted in compassion, collaboration, and ... healthcare, leadership, or business required; Master's degree preferred. + Current Montana RN license (or compact equivalent) required. + Minimum of five (5) years'… more
- Nuvance Health (Danbury, CT)
- …with all above parties to submit provider appeals to insurance companies including Medicare and Medicaid for the Nuvance Health network. The role also provides ... department operation. Performs a full range of computer/clerical duties in compliance with Hospital, Governmental, and Regulatory requirements. Works within a… more
- Humana (Springfield, IL)
- …Mobile Crisis Response and vendor management, developing novel solutions and ensuring compliance with state and federal regulations. + Ensures that all behavioral ... accreditation requirements, supporting a culture of continuous improvement and compliance across the organization. + Champions cross-functional and enterprise… more
- Arnot Health (Elmira, NY)
- …interpretation of regulatory standards, including The Joint Commission and Centers for Medicare and Medicaid Services (CMS); ensures a constant state of readiness; ... leadership and assistance to enterprise-wide initiatives. Performance Improvement and Compliance : Duties and Responsibilities: ** 1. Assumes the daily organizational… more
- UNC Health Care (Rocky Mount, NC)
- …observation, etc. 3. Compliance /Clinical Quality Improvement: Assists in achieving compliance with the Joint Commission, Centers for Medicare and Medicaid ... medical problems in all clinical situations and reports these to MD or RN ; Recognizes unsafe exercise situations and intervenes to ensure patient safety; Monitors… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …promotes quality healthcare delivery, manages healthcare costs, and ensures compliance with regulatory and accreditation requirements. This position is responsible ... Oversee Utilization Management to ensure alignment with organizational goals and compliance with regulations. + Develop, implement, and monitor strategies to manage… more
- Commonwealth Care Alliance (Boston, MA)
- …and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and ... has a key role in ensuring CCA meets CMS compliance standards in the area of service decisions and...clinical areas, including but not limited to surgical procedures, Medicare Part B medications, long term services and supports… more
- Marshfield Clinic (Beaver Dam, WI)
- …all resident care and business decisions. Ensure the facilities operate in compliance with all local, state, and federal regulations. Interacts with residents, ... **ESSENTIAL JOB FUNCTIONS** 1. Development of a qualified team to ensure compliance with Federal and State Codes. 2. Provides direct accountability leadership,… more