- Novo Nordisk Inc. (WA)
- …Corporate Tax, as well as other Market Access & Public Affairs teams, Medical , Legal, Compliance , Communications and other key stakeholders locally and globally. ... External relationships include select federal agencies that may develop health care policies that...insights from other departments (Corporate Tax, MA, Comm'l BUs, Medical , Regulatory, Legal, etc) Assigned policy areas may include,… more
- CVS Health (St. Louis Park, MN)
- …performance, cost structure and local execution of medical costs management, Medicare Stars, member engagement, compliance , and revenue integrity efforts for ... and drive cost structure reduction (SAIs) in collaboration with Medicare segment leadership, the market medical teams,...implementation and maintenance of policies and procedures to ensure compliance with the State and Federal regulatory… more
- CVS Health (Hartford, CT)
- …Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary on the non-regulated appeals team, however the ... 72 hour turn around time * Collaborative work with Medicare Quality and Compliance on an ongoing...Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance &… more
- Humana (Jacksonville, FL)
- …and contracting teams to promote provider engagement with CarePlus and ensuring compliance and marketing guidelines associated with Medicare regulations are ... a part of our caring community and help us put health first** Our Senior Manager, Medicare Sales - CarePlus motivates and drives a team of Medicare Sales Field… more
- The Cigna Group (Bloomfield, CT)
- …position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This actuarial ... to provide a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with internal leadership within… more
- Commonwealth Care Alliance (Boston, MA)
- …care reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and ... Working under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …research activity in an academic medical center + Knowledge of billing compliance and Medicare regulations/policy, applicable federal , state, and local ... the Medicare Clinical Trial Policy (NCD 310.1) and designates medical procedures/services based on relevant regulations and determinations. The Senior … more
- Aston Carter (Honolulu, HI)
- …interdepartmental activities, and the reference materials supporting these Ensuring that all Medicare member records are in compliance with CMS requirements and ... of enrollment information and demographic changes (including coordination of benefit, Medicare Secondary Payer and Medicare Late Enrollment Penalty information),… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities....an equal opportunity employer and fully supports and maintains compliance with all state, federal , and local… more
- CVS Health (Frankfort, KY)
- …success working to build new technologies and software to support member materials compliance + Knowledge of Medicare Advantage rules, including the Medicare ... **Position Summary** This individual contributor position reports to the Lead Director, Medicare Member Materials. This is an exciting opportunity to join our team!… more
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