- Molina Healthcare (ID)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- Humana (Madison, WI)
- …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales motivates and drives a team of Medicare ... and train a team of sales individuals. The Senior Manager , Medicare Sales must have a solid...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Houston Methodist (Katy, TX)
- …Access Services, and Utilization Review as needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… more
- Amazon (San Francisco, CA)
- Description We are seeking an experienced Clinical Quality Manager for Senior Health to join Amazon One Medical. Reporting directly to the National Leader for ... quality performance for One Medical Seniors throughout the country, focusing on Medicare Advantage Stars and ACO REACH programs, driving excellence in healthcare… more
- Molina Healthcare (Layton, UT)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… more
- CVS Health (Phoenix, AZ)
- …each and every day. **Position Summary** As an Audit and Testing Program manager , you will provide technical, analytical, and business support for all assigned ... programs for Medicare , Medicaid, and Commercial products. Programs currently include End-Stage...will also be required to speak to Med D compliance and reporting documentation associated with our clinical programs.… more
- The Cigna Group (Bloomfield, CT)
- This position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This ... Drug or Part D bid development consulting experience preferred + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager (PBM) / Healthcare /… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… 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
- Healthfirst (NY)
- …and ad hoc material reviews including assisting the Regulatory Affairs Manager by reviewing, finalizing, submitting, and tracking approvals of material reviews ... in HPMS. + Actively participates in the annual Medicare Go to Market process, including working with internal...review of the website with business owners and ensures compliance with regulatory requirements specific to annual Go to… more
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