- Gentiva (Stevens Point, WI)
- …Titles Hospice RN leadership, Director of Clinical Services jobs, Hospice nurse director , Hospice compliance RN, and Medicare Hospice regulations ReqID: ... Care. Transform Hospice Services.** We are seeking a RN Director of Clinical Services to join our team. Reporting...responsible for ensuring the appropriate delivery of hospice services, compliance with Medicare Hospice Benefit Conditions of… more
- Elevance Health (Tampa, FL)
- **Medical Director - Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... Florida near our Miami or Tampa locations.** The **Medical Director ** will support the following Florida Medicare ...+ Ensure timely and accurate completion of reviews in compliance with state and federal regulations, NCQA, and company… more
- CVS Health (Hartford, CT)
- …based (work at home) based anywhere in the US.** **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on ... and Utilization Management Strategy support * Collaborative work with Medicare Quality and Compliance on an ongoing basis * Develop subject matter expertise… more
- Molina Healthcare (Sterling Heights, MI)
- …to meet critical needs + Escalates gaps and barriers in implementation and compliance to AVP, VP and senior management + Consultative role, develops business case ... methodologies for programs, develops and coordinates implementation of business strategy + Collaborates and facilitates activities with other units at corporate and Molina Plans. **JOB QUALIFICATIONS** **Required Education** Bachelor's degree or equivalent… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements: The physical requirements described ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and...additional marketing locations while adhering to company regulatory guidelines. Compliance + Requires continues education to stay abreast on… more
- Humana (South Miami, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Cleveland Clinic (Cleveland, OH)
- …the Federal Clinical Trials Policy. In this role, you will report to the Director of Research Medicare Coverage Analysis and ensure compliant research billing ... financial services, clinical research billing office, IRB and research compliance related to Medicare coverage analysis issues...clinical trials for research billing. + Assist the MCA Director on the development of tools and billing grids… more
- Community Health Systems (La Follette, TN)
- …are submitted in accordance with regulatory guidelines and organizational policies. The Medicare Billing Specialist supports compliance with federal and state ... **Job Summary** The Medicare Billing Specialist is responsible for performing timely...Ensures documentation and billing practices align with audit and compliance expectations. + Escalates unresolved billing issues or delays… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance , Healthcare Medical Claims Coding ... reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and Analytics… more
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