- Roper St. Francis (Ladson, SC)
- …of managed care arrangements, including value-based arrangements, ensuring compliance with contractual agreements and regulatory requirements. + Monitor ... managed care processes with overall organizational goals. + ** Compliance & Quality Assurance:** + Ensure adherence to federal,...Managed Care - Contracting - Roper St Francis Healthcare _It is our policy to abide by all… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …a bridge between stakeholders, including Managed Care Plans (MCOs and PAHPs), healthcare providers, and regulatory bodies, with a focus on improving ... of healthcare policies and regulations related to managed care. Develop strategies for compliance and...the Iowa Medicaid division, Managed Care Plans, healthcare providers, and regulatory agencies. Facilitate collaboration… 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
- Dignity Health (Bakersfield, CA)
- …Dignity Health MSO. - Establish and enforce policies and procedures to ensure compliance with regulatory requirements and industry standards. - Oversee the ... care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health… 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
- 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
- Molina Healthcare (New York, NY)
- …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
- LA Care Health Plan (Los Angeles, CA)
- … Regulatory Operations Project Manager II manages a portfolio of complex regulatory change management and compliance projects. This position will develop and ... drives continued progress for project success; develops strategies for achieving compliance with state and federal regulatory , contractual and accreditation… 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
- Molina Healthcare (Waltham, MA)
- …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
- 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
- BeiGene (Emeryville, CA)
- …+ May provide regulatory advice on appropriate relationships with healthcare professionals, patients, managed care entities, advocacy organizations, and ... products in North America. This role supports our commercial, medical affairs, legal, healthcare compliance and other business functions in the United States and… more
- Banner Health (Mesa, AZ)
- …of of facility/entity policies, procedures and guidelines as they relate to regulatory compliance . Makes recommendations on all facility matters related to ... this could be the perfect opportunity for you. Becker's Healthcare recently honored Banner as one of 150 top...on an ongoing basis. Updates senior leadership on system regulatory compliance trends and certification/accreditation bodies most… 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
- Aveanna (Atlanta, GA)
- Director, Regulatory Licensing ApplyRefer a FriendBack Job Details Requisition #: 194333 Location: Atlanta, GA 30339 Category: Management Salary: Starting at ... you passionate about making a difference in people's lives through superior home healthcare ? Look no further! Aveanna Healthcare is seeking dedicated individuals… more
- Robert Half Legal (Rancho Cucamonga, CA)
- …team and become a Managed Care expert (MediCare). You will advise on regulatory and compliance issues, and a critical HIPAA advisor. The company is subject ... executive briefings for leadership. + Be a Subject Matter Expert & Trust Managed Healthcare Advisor: Attend meetings with different business units, analyze legal… more
- Organon & Co. (Plymouth Meeting, PA)
- …current regulatory trends and guidelines. Ensure technical congruency and regulatory compliance , meeting agreed upon timelines and e-publishing requirements. ... regulatory approval timeline and how this will be managed . + Responsible to ensure regulatory requirements...their best lives. We are a $6.5 billion global healthcare company focused on making a world of difference… more
- Molina Healthcare (MA)
- …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **The focus of this position will be member outreach… more
- Molina Healthcare (AZ)
- …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **A background in quality/HEDIS is very important for this… more
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