- Molina Healthcare (Phoenix, AZ)
- **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
- CVS Health (Phoenix, AZ)
- …care objectives. Working cross-functionally with Duals Center of Excellence, clinical, compliance , analytics and network teams, the Senior Manager drives ... Leads the strategy, design, development and life cycle management of Aetna Medicare products that serve Medicare Advantage populations, including Chronic Care… 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
- Molina Healthcare (Chandler, AZ)
- …business areas and owners to ensure processes and reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with ... to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Molina Healthcare (Scottsdale, AZ)
- …integration, and a strong understanding of data governance and compliance in healthcare environments. **Knowledge/Skills/Abilities:** * Architect and implement ... Deploy, monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and … more
- Cardinal Health (Phoenix, AZ)
- …of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **_What is ... **_What Ethics & Compliance contributes to Cardinal Health_** Ethics & ...facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines;… more
- Humana (Phoenix, AZ)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...+ Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with… more
- Molina Healthcare (Mesa, AZ)
- …as needed + Primary point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations. Coordinates and facilitates ... including goal setting and score card development + Monitors and enforces compliance with enterprise-wide processes and develops workflows for all staff to follow… more
- Humana (Phoenix, AZ)
- …industry in how digital can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are aggressively driving new digital ... of working, and employing next-gen technology to revolutionize how Medicare Advantage is sold. This role is part of...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- J&J Family of Companies (Tucson, AZ)
- …Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Tucson, AZ; ... help overcome challenges to fulfillment, on-boarding, and adherence. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead… more
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