- Weisman Children's Rehabilitation Hospital (Marlton, NJ)
- …Medical Director is also responsible for administrative oversight and outcomes for clinical providers designated to their area. Keeps a medical history and medical ... with the remaining time dedicated to administrative duties related to oversight of clinical provision of care in their area.* Requires a solid understanding of how… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …we need: As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as ... escalate to senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity… 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
- BrightSpring Health Services (Arlington, TX)
- …focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh ... calls/claims per hour as determined by the Director and Clinical Hub Manager + Provide clinical support...Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and State Laws, and applicable… more
- University of Maryland, Baltimore (Baltimore, MD)
- *The University of Maryland, Baltimore*(UMB) is seeking a*Corporate & Clinical Trials Contracts Senior Associate* in the Center for Clinical Trials and ... clinical and/or corporate contracts and collaboration agreements in compliance with sponsor, federal, state and university policies and regulations. Familiarity… more
- Option Care Health (Chicago, IL)
- …vaccinated, or your employment will be terminated. **Job Description Summary:** The Senior Manager, Compliance Auditing, Monitoring and Analytics is responsible ... and abuse, including but not limited to HIPAA, Anti-Kickback, Stark, Medicare /Medicaid reimbursement. Experience evaluating information to determine compliance … more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** The Senior Quality Compliance Nurse Professional is an integral part of the Oklahoma ... goals and complete time sensitive deliverables for Quality Improvement clinical and non- clinical performance projects. The role...role operates as a subject matter expert in Quality Compliance . The Senior Quality Compliance … more
- Rush University Medical Center (Chicago, IL)
- …5:00:00 PM) **Summary:** This position will create coverage analyses in accordance with Medicare 's Clinical Trial Policy (NCD 310.1) and assist research staff ... provide high-level professional support in the growing efforts to conduct prospective Medicare Coverage Analysis for all clinical research studies. Exemplifies… more
- Rush University Medical Center (Chicago, IL)
- …Research Revenue Cycle, this position will create coverage analyses in accordance with Medicare 's Clinical Trial Policy (NCD 310.1) and assist research staff ... provide high-level professional support in the growing efforts to conduct prospective Medicare Coverage Analysis for all clinical research studies. Exemplifies… more
- The Mount Sinai Health System (New York, NY)
- …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject ... within Mount Sinai. The team includes 400+ employees with clinical , contracting, finance, IT, analytics, operations, and product development expertise.… more
- Scripps Health (San Diego, CA)
- …our employees have been with Scripps Health for over 10 years. The Chargemaster Senior Analyst provides assistance and analysis to all levels of clinical ... and researches and communicates coverage guidelines for billable services. Works with clinical directors and managers to implement and monitor CDM changes. Provides… more
- University of Michigan (Ann Arbor, MI)
- Reimbursement Analyst Senior Apply Now **How to Apply** A cover letter is required for consideration for this position, and it should be attached as the first page ... and government entities. The reimbursement analyst will maintain current knowledge of Medicare , Medicaid and other State and Federal regulations. The analyst also… more
- Bristol Myers Squibb (Boston, MA)
- …. Reporting into the Medical Value Liaison Field Director, the Senior Medical Value Liaison (MVL)/Executive MVL is a field-based role focused ... on applying clinical expertise and experience/knowledge of payors, health policy, payer...policy makers, and other decision makers and influencers. **Responsibilities** ** Senior Medical Value Liaison** + Provide comprehensive, accurate, fair,… more
- AdventHealth (Orlando, FL)
- **AdventHealth HIM Coding** ** Senior Medical Coder - Inpatient Coding Specialist** **All the benefits and perks you need for you and your family:** . Paid Parental ... The Inpatient Coder is responsible for reviewing, analyzing, and interpreting clinical documentation in the medical record, applying appropriate ICD-10-CM/PCS coding… more
- Beth Israel Lahey Health (Boston, MA)
- …of America) Under the general direction of the Associate Director of the Clinical Trials Office (CTO), the Senior Contracting Specialist works with ... clinical research. + Understands and keeps current with FDA and Medicare regulations applicable to clinical trials. Implements rules, regulations, guidelines… more
- Rush University Medical Center (Chicago, IL)
- …requirements specific to Research Billing. * Maintain a detailed understanding of Medicare 's Clinical Trial Policy (NCD 310.1) and related guidance documents. ... Responsible for managing, reconciling and invoicing all revenue secured by Clinical Trials Research Revenue Cycle, work closely with operations, sponsors, and… more
- Aveanna (Madison, WI)
- …RN Clinical new hires * Provides ongoing training and educational opportunities for Clinical staff * Serves as a senior member to all staff regarding quality ... Home Health RN Assistant Clinical Manager ApplyRefer a FriendBack Job Details Requisition...agency policy and procedures and state/federal regulation * Ensures compliance with regulations and is available for federal and… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …enhance collaboration for successful business outcomes. + Oversite, direction for pharmacy clinical programs and associated compliance with regulatory (eg State, ... team, comprised of pharmacists and nurses, Pharmacy Product , Pharmacy Clinical Quality and Medicare Advantage + Attract, retain, and coach a high performing… more
- LA Care Health Plan (Los Angeles, CA)
- Senior Director, Care Management Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... role will oversee and manage a large team of clinical and non- clinical staff while working in...up, care coordination and Disease Management while maintaining regulatory compliance and operational efficiency and excellence. The Senior… more
- University of Oregon (Eugene, OR)
- …Senior Staff Therapist/Psychologist Apply now ... in collaboration with other University departments. Position Summary The Senior Staff Therapist/Psychologist provides psychological intervention, prevention, and postvention… more
