- LA Care Health Plan (Los Angeles, CA)
- …and continuous improvement of the Fraud, Waste, and Abuse (FWA) program, ensuring compliance with Centers for Medicare and Medicaid Services (CMS), Department of ... and Culture: Serve as a trusted advisor and subject matter expert to senior leadership, the Compliance Committee, and the Audit Committee on investigative… more
- Humana (Springfield, IL)
- …Description Summary Humana Gold Plus Integrated is seeking a Quality Improvement Professional to implement quality improvement programs for all lines of business ... description, work plan, and annual evaluation. The Quality Improvement Professional performs quality investigations to implement and support quality improvement… more
- Commonwealth Care Alliance (Boston, MA)
- …network performance against internal and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. * ... provider operations and satisfaction. * Strong understanding of Medicare and Medicaid health plan operations, including regulatory and compliance requirements.… more
- Humana (East Saint Louis, IL)
- …the implementation of the Community Engagement Team for the Humana Illinois Medicaid Market by working collaboratively with the Health Equity, Clinical, Quality, ... and community-based visits as needed to ensure effective administration of the Medicaid program- including occasional night and weekend events **Use your skills to… more
- Sysco (Houston, TX)
- …developing relationships with current and perspective customers in Acute Care, Senior Living, and Long-Term Care sectors that traditionally require expertise around ... nutritional requirements, regulatory compliance , menu development, disaster planning, and Group Purchasing Organizations. This role will execute targeted strategies… more
- Service Source (Springfield, VA)
- …services being provided by assigned personnel. + Maintain participant files in compliance with Medicaid , Licensing, and CARF standards, etc. Coordinate with ... Established promotion opportunities and clear career pathways ({Program Manager >> Sr . Program Manager/ Division Manager >> Director)) + Tuition reimbursement and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …**The opportunity** The Associate Director of Federal Account Management reports to the Senior Director Federal National Accounts and Medicaid and is responsible ... including aligned territory account managers and HEOR/medical + Responsible for supporting the Sr . Director, Federal National Accounts & Medicaid in speed to… more
- AdventHealth (Maitland, FL)
- …and Ancillaries. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms. This affords AdventHealth ... net patient revenue for the Florida division. This position assists the Sr . Contract Manager with ensuring that preferred contract language provides for ease… more
- HCA Healthcare (Salem, VA)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... patient + Demonstrates excellent customer service + In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house + Provide estimates to… more
- HCA Healthcare (Gainesville, FL)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... patient + Demonstrates excellent customer service + In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house + Provide estimates to… more