- Humana (Washington, DC)
- …Transformation Program team is a high-performing team that works closely with senior leaders to help chart the course for the company's future. Transformation ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Group ... standard formulas and actuarial information, recognizing system requirements and ensuring compliance with state and federal regulations, and adherence to internal… more
- CenterWell (Phoenix, AZ)
- …other providers to form a narrow network of quality service focused on senior population health + Responsible for medical interpretation, reviews, and decisions as ... the organization in community and marketing events. + Develop and maintain compliance with the departmental and physician budgets. + Assess, develop and recommend… more
- Humana (Olympia, WA)
- …caring community and help us put health first** Humana is seeking a Senior Responsible AI Data Scientist to champion the ethical development of artificial ... through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to… more
- Avera (Sioux Falls, SD)
- …you and our patients. Work where you matter.** **A Brief Overview** The Senior Coding Auditor is responsible for auditing technical and professional services. The ... on education and/or improvement plans. Emergent reviews may be performed based on compliance and clinical need. This individual will be required to understand and… more
- MetroLink (Los Angeles, CA)
- …of federal, state, regional, and local funding + Responsible for assuring compliance with federal and state regulations and guidelines through timely execution of ... appropriate + Ensure high-quality work output of departmental and consultant staff + Establish, monitor, and reinforce department policies...environment, with an emphasis on grants administration at a senior level. + Minimum of five (5) years of… more
- CenterWell (Savannah, GA)
- …Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 340 centers across ... care team supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care we want to help those in the communities we… more
- CenterWell (Norfolk, VA)
- …other providers to form a narrow network of quality service focused on senior population health. + Responsible for medical interpretation, reviews, and decisions as ... indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally… more
- The Joint Commission (Oakbrook Terrace, IL)
- …from the field, analysis of periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of- compliance reports. + ... experience in orthopedics, and 2 years of accreditation or certification leadership or senior management experience. Recent experience as a consultant to health… more
- J&J Family of Companies (Santa Clara, CA)
- …and experience working with KOLs, physician specialty societies, sales teams and senior management. Reporting directly to the Sr. Director of Market Access and ... corporate objectives and payer dynamics. + Serve as a senior leader within the Market Access team, contributing to...internal cross-functional leaders (eg, Sales, Marketing, Medical Affairs, Legal, Compliance ). + Serve as a key point of escalation… more