- The Cigna Group (Nashville, TN)
- **Summary** The Data Governance & Ownership (DG&O) Senior Manager will work with the Provider Data Quality & Accuracy (PDQA) Director to establish the framework ... Functions and Responsibilities** + Coordinate and partner with the key Medicare operations teams, including claims, enrollment, fulfillment, network operations, and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the creation of controls to manage fraud, waste and abuse schemes. + Support the Medicare compliance program by overseeing Medicare fraud waste and abuse ... Prevention (FIP) Unit including management of a team of senior managers, data analysts, fraud investigators, certified coders and...on fraud waste and abuse work, present to the Medicare Compliance Committee and manage requests and… more
- Plante Moran (Columbus, OH)
- Healthcare Reimbursement - Consulting Sr . Manager + Location: United States, Ohio, Columbus + Location: United States, Ohio, Cleveland Make your mark. Our ... senior care healthcare consulting team focuses on our clients'...manage strategic engagements focused on preparation of Medicaid and Medicare cost reports + Prepare, review, and analyze SNF… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Senior Risk Manager Full-Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's top-performing ... by Forbes as a Best Employer. Position Summary: The senior risk manager is responsible for the...Licensure Requirement: Current Tennessee RN license Apply/Share Job Title SR RISK MANAGER ID 4064924 Facility Covenant… more
- University of Miami (Miami, FL)
- …& Operations to work at the UHealth Medical Campus. Core Summary The Senior Manager , Facilities & Operations administers leadership for various projects, ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sr . Manager , Facilities & Operations The department… more
- American Heart Association (Dallas, TX)
- …career. The American Heart Association has an excellent opportunity for a ** Sr . Program Development Manager , Data Solutions, Performance Measures** supporting ... This position works with data quality, use, and other compliance processes. This position is a frequent liaison between...a specific HIT strategic plan supported by volunteers and Senior Management, aligning with Quality and Health IT's overall… more
- Healthfirst (NY)
- …Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. ** Compliance & Regulatory Responsibilities:** Noted ... on all aspects related to one or more specific Medicare performance areas such as Risk Score Accuracy, ...Medicare performance areas such as Risk Score Accuracy, Medicare Clinical Programming and Operations, Provider Performance, Medical and… more
- Molina Healthcare (South Florida, FL)
- …metrics/Risk Adjustment will receive first consideration.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions / QI Compliance ... more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-, program-, and… more
- The Cigna Group (Springfield, IL)
- The **Regional Medicare ** **Provider Contracting Senior Manager - Midwest** serves as an integral member of the Network Development and Solutions Team and ... reports to the Medicare Provider Contracting Regional Vice President. This role is...local market provider engagement, claims operations, clinical, Legal, analytics, compliance , sales, and provider relations. + Manages strategic positioning… more
- CareOregon (Portland, OR)
- Job Title Sr Accountant Exemption Status Exempt Department Finance Manager Title Accounting Supervisor - Ops Direct Reports n/a Requisition # 24549 Pay and ... Portland, Oregon or SW Washington. Job Summary This position performs senior level accounting functions for the organization. Primary responsibilities include… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** Waystar is seeking a smart and creative Senior Product Manager with hands on experience in Healthcare Revenue Cycle Management. We are ... closely with User Experience team and Technology teams. The Senior Product Manager will lead cross departmental...industry standards and staying up-to-date on industry changes and compliance issues + Gathering inspiration and ideas by visiting… more
- The Cigna Group (Bloomfield, CT)
- …which is a Band 3 Management Career Track Role. **Customer Service Senior Supervisor- Medicare ** The Government Business CTM (Complaint Tracking Module) Complaint ... Resolutions Senior Supervisor is a... manager of CTMs. This role will support the Medicare Advantage line of business by directly supervising the CTM… more
- Access Dubuque (Dubuque, IA)
- …department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... Staff Accountant Sr -Financial Plan **UnityPoint Health Finley Hospital** 1 Positions...Overview** **Overview** Reporting to the VNA Director, the VNA Senior Staff Accountant provides all financial oversight of VNA… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **38319BR** **Extended Job Title:** Sr Med Billing Assoc **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Employees in this position ... to process patient and/or insurance refunds for the Institutional Office of Compliance and/or Audit Services timely and accurately as defined by their audit… more
- Precise Systems, Inc. (Lexington Park, MD)
- …exceptional service and the Precise solution. We are currently seeking a Senior Benefits Specialist. This individual will be responsible for coordinating, procuring, ... implementing, ensuring compliance , and administering Precise Systems' employee benefit programs, as...and administering the Wellness program. Distinguishing Characteristics Further, the Senior Benefits Specialist will serve as a resource for… more
- Commonwealth Care Alliance (Boston, MA)
- …Department Regulatory Affairs and Compliance infrastructure at CCA. + Promote compliance in CCA's business operations with all Medicare and Medicaid ... Program + Contribute towards the maintenance and enhancement of an effective Compliance Monitoring Program + Contribute towards the maintenance and enhancement of an… more
- Molina Healthcare (NM)
- …and monitoring for key performance measurement activities. **Knowledge/Skills/Abilities** The Senior Specialist, Provider Engagement contributes to one or more of ... interventions (eg, removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities. *… more
- The Cigna Group (Bloomfield, CT)
- …member of the Network Development and Strategy Team and reports to the Provider Contracting Senior Manager . This role is a key contributor to the development of ... value-based reimbursements with hospitals and other providers for Cigna's Medicare product lines (eg, Hospital systems, Ancillaries, and large physician… more
- The Cigna Group (Austin, TX)
- …who service existing and new customers. The Direct To Consumer (DTC) Conservation Senior Supervisor will monitor key performance indicator metrics and work with the ... DTC Retention Operations manager to oversee the entire conservation administration process. They...increasing performance, overall productivity and skill sets. + Facilitates compliance with all corporate policies. + Handles multiple assignments… more
- The Cigna Group (Bloomfield, CT)
- …The **Project Manager ** is a key role that supports **Cigna's Medicare Advantage** line of business, directly addressing customer and client demands for higher ... quality of care and greater affordability for the senior population. The primary focus for this role includes...service performance outcomes within their assigned segment(s). The **Project Manager ** will serve as a liaison between the National… more