- Medical Mutual of Ohio (Brooklyn, OH)
- …perform pre-employment substance abuse and nicotine testing._ **Title:** _Senior Medicare Compliance Analyst_ **Location:** _OH-Brooklyn_ **Requisition ID:** ... Implements and manages the implementation and daily operation of the Medicare Advantage Compliance Program and all compliance -related activities for the… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …location for this position is full remote with occasional time onsite.** The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research ... which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical...in an academic medical center + Knowledge of billing compliance and Medicare regulations/policy, applicable federal, state,… more
- Providence (WA)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... to optimize performance + Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements + Collaborating with… more
- The Cigna Group (Seattle, WA)
- **Role Summary:** The Provider Performance Lead Analyst is a key member of the market that assists in the growth and development of the provider network. The Lead ... Analyst is the primary conduit to the providers and...+ Developing time and cost effective territory management in compliance with department and enterprise goals. + Understanding, developing,… more
- The Cigna Group (Sunrise, FL)
- …primary conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst 's responsibilities ... **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market...leadership + Developing time and cost-effective territory management in compliance with department and enterprise goals. + Understanding, developing,… more
- Actalent (Phoenix, AZ)
- Job Title: Clinical Trial Coverage Analyst Job Description We are seeking a Clinical Trial Coverage Analyst to join our pre-award team. The primary ... items to insurance, based on federal and state billing regulations, including Medicare 's National Coverage Decision (NCD) 310.1. This role requires a keen… more
- UCLA Health (Los Angeles, CA)
- …this and more at UCLA Health. As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running processes/jobs ... required * Five or more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5 years of experience with Encounter… more
- The Cigna Group (Bloomfield, CT)
- …medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts. **Essential Duties ... medical necessity and appropriateness of setting according to established policies and compliance guidelines. * Uses an established set of criteria to evaluates and… more
- The Cigna Group (Bloomfield, CT)
- …medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts. **Essential Duties ... medical necessity and appropriateness of setting according to established policies and compliance guidelines. + Uses an established set of criteria to evaluates and… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Actuarial Analyst 2, Risk and Compliance supports the overall management and oversight of ... develops and recommends controls and cost-effective approaches to minimize risks. The Actuarial Analyst 2, Risk and Compliance work assignments are varied and… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Regulatory Compliants & Inquires) - Remote **Job Description** ... The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs and may lead some initiatives… more
- Penn Medicine (Bala Cynwyd, PA)
- …employees shape our future each day. Are you living your life's work? **Hospital Compliance Analyst II** Job Summary: + Responsible for the performance and ... at all hospitals owned by Penn Medicine to assure compliance with applicable federal and state coding and billing...by Senior leadership, and Director. + Apply knowledge of Medicare Outpatient Prospective Payment System guidelines to confirm that… more
- University of Michigan (Ann Arbor, MI)
- HEALTH INFORMATION MANAGEMENT ANALYST II - HEALTH RECORD COMPLIANCE DEFICIENCY MANAGEMENT Apply Now **Job Summary** To assist physicians and other clinicians ... **Job Detail** **Job Opening ID** 253693 **Working Title** HEALTH INFORMATION MANAGEMENT ANALYST II - HEALTH RECORD COMPLIANCE DEFICIENCY MANAGEMENT **Job… more
- CareFirst (Baltimore, MD)
- …Preferred or + Lean Six Sigma Certification-IASSC Preferred or + Certified Regulation Analyst Preferred or + Certified Compliance & Ethics Professional (CCEP) ... compliance programs, or related fields. **Preferred Qualifications:** + Healthcare Compliance certification(s). + Experience in CMS programs ( Medicare or… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst (Regulatory Intelligence and Assessment) - Remote **Job Description** ... The Senior Compliance Analyst assists in the implementation of...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The ... Senior Compliance Analyst assists in the implementation of...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Compliance , Legal and Security departments to meet business needs. The MDM Analyst will assist the DGO, Compliance , Legal and Security with strategy, policy ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....possible health and quality of life. Master Data Management Analyst I-IV The MDM Analyst within the… more
- Penn Medicine (Bala Cynwyd, PA)
- …shape our future each day. Are you living your life's work? **Senior Hospital Compliance Analyst ** Job Summary: + Responsible for the performance and validation ... documentation reviews at all hospitals owned by Penn Medicine to assure compliance with applicable federal and state regulations. Incumbent will also participate in… more
- University of Rochester (Rochester, NY)
- Responsibilities **Position Summary:** **This position oversees outpatient Medicare , Medicaid and third-party payor audits, and directs all responses to assure ... for all internal and external sources regarding routine audits, including Medicare and Medicaid credit balance quarterly audits, audits obtained from the… more
- Medical Mutual of Ohio (OH)
- …coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider Analyst II** ... assisting with analyses, projects, etc. Supports negotiation and contract interpretation and compliance . . Work on various special projects and ad-hoc reports on an… more