- Amergis (Fresno, CA)
- …mentor Compliance Department staff. + Prepare and submit DHCS/DMHC regulatory filings and responses to "Additional Information Requests" and "Comment Letters". + ... At Amergis Healthcare Staffing we are passionate about connecting people...+ Seven to ten years' progressive experience in Medi-Cal Managed Care compliance is required. + Senior… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …practices. Apply this knowledge to enhance the contracting strategies and operations. + Regulatory Compliance : Ensure that all managed care contracts comply ... PHO entity. Provide strategic leadership, operational oversight, financial management, regulatory compliance management, and maintain stakeholder engagement. +… more
- Roper St. Francis (Charleston, SC)
- …of Position** Manages the overall operations of managed care including managed care contract negotiations, analysis, and compliance activities in support of ... or report to leadership, as appropriate, issues related to Managed Care payer compliance with contractual payment...Managed Care - Contracting - Roper St Francis Healthcare _It is our policy to abide by all… more
- Cedars-Sinai (CA)
- …Completes focused reviews and special reports as requested. + Collaborates with the healthcare team to implement strategies to resolve system issues. + Serves as the ... the network's membership. + Monitors and Tracks all other aspects of Managed Care, quality & efficiency measures, Star ratings, access, physician network integrity,… more
- MaineGeneral Health (Waterville, ME)
- …and payer enrollment. The successful candidate will have a deep understanding of healthcare finance, regulatory requirements, and a proven track record in a ... or related field (Master's preferred) + Minimum of 7 years of experience in healthcare reimbursement and managed care - some leadership experience is preferred +… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is responsible for managing the payor contracting functions for the hospitals, ... of Henry Ford Health. This position is responsible for leading the Managed Care Contracting team in evaluating, analyzing, and negotiating contract terms and… more
- Cedars-Sinai (Beverly Hills, CA)
- …metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for compliance and financial performance, identifying ... implementation financial initiatives; assisting in the interpretation of policies/procedures/practices. Managed Care Reporting: + Prepare reports and presentations to… more
- Sutter Health (Goleta, CA)
- …(TJC). A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. Must be able to effectively communicate with, and ... & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + CCM - Certified Case Manager (certification may be required… more
- LA Care Health Plan (Los Angeles, CA)
- Regulatory Compliance Quality Audit Specialist Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... units in audit universe preparation and validation. Assists in document preparation for regulatory and internal audits. Regulatory compliance : Works closely… more
- CSL Behring (King Of Prussia, PA)
- …broader commercial organization. + Good understanding of all associated legal, compliance and regulatory requirements. Additional Information: + Current ... Reimbursement leadership to overcome product access obstacles. + Analyze the US healthcare market trends, healthcare reform, and relevant business models to… more
- Robert Half (Charlotte, NC)
- JOB REQUISITION East Region Risk & Compliance Regulatory Managing Director LOCATION CHARLOTTE ADDITIONAL LOCATION(S) JOB DESCRIPTION Risk & Compliance - ... Include the Following? + Deep knowledge of bank and/or credit-related regulatory requirements, specifically related to consumer compliance regulations (eg,… more
- US Tech Solutions (Columbia, SC)
- …Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and ... system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory… more
- Robert Half (Boston, MA)
- JOB REQUISITION Risk and Compliance - Healthcare - Senior Manager LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB DESCRIPTION ... Need You Protiviti is looking for a Risk and Compliance Senior Manager to join our growing Healthcare...of commonly used internal control frameworks, risk frameworks and regulatory / compliance methodologies. + Expertise of risk assessment… more
- Robert Half (Boston, MA)
- JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB ... Need You Protiviti is looking for a Risk and Compliance Senior Consultant to join our growing Healthcare...of commonly used internal control frameworks, risk frameworks and regulatory / compliance methodologies . + Expertise of risk… more
- Molina Healthcare (Williamsburg, VA)
- …Public Health, Social Work, or related field. **Required Experience** + 5+ years of managed healthcare experience, including 3 or more years in one or more ... **Preferred Experience** + 3+ years supervisory/management experience in a managed healthcare environment. + Medicaid/Medicare Population experience with… more
- Molina Healthcare (Los Angeles, CA)
- …. The Dir, Vendor Management will also oversee and monitor vendors' compliance with state and federal regulatory requirements. **KNOWLEDGE/SKILLS/ABILITIES** * ... procurement teams to optimize the cost-effectiveness of negotiations and ensure compliance of negotiated agreements relating to regulatory requirements, services… more
- Molina Healthcare (IA)
- …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Analyst, Quality Improvement (QI) Interventions/… more
- Banner Health (AZ)
- …knowledge resource for the revenue cycle. Identifies, problem-solves and troubleshoots emerging compliance , coding and billing regulatory risks. This may include ... to leverage your abilities - you belong at Banner Health. The Regulatory Project Coordinator responsibilities include daily research on variety of different topics… more
- Olympus Corporation of the Americas (Westborough, MA)
- …sustaining ( compliance ) for launched products, in conjunction with Olympus Regulatory Affairs team. + Provide guidance, and oversight to DU development teams ... than @Olympus.com, it is likely not legitimate._ **Job Description** The Regulatory Affairs (RA) Program Manager Digital Strategy is responsible for coordinating… more
- Molina Healthcare (Madison, WI)
- …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist, Quality Interventions/ QI … more
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