- Option Care Health (Chicago, IL)
- …fully 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
- Careerbuilder-US (Atlanta, GA)
- Job Title: Senior Professional Coder Location: Newark, NJ, 07105 (Remote) Job Duration: 3 months+ with possible extension Shift Time: 8:30 AM - 5PM - 5 Days a week. ... Job Description: . The Senior Professional Coder provides services to perform code abstraction...programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit),… more
- Erickson Senior Living (Houston, TX)
- …Therapy treatments to meet resident's needs in all settings across the Erickson Senior Living community continuum of care Following Medicare , state and federal ... Location: Eagle's Trace by Erickson Senior LivingEagle's Trace is a beautiful 70-acre continuing...company policies and procedures and ensure departmental understanding and compliance in the areas of care provision, documentation, billing… more
- Erickson Senior Living (Baltimore, MD)
- …growth with an enterprise wide focus to include, medical center operations, Medicare Advantage, and healthcare strategy for Erickson Senior Living. This ... Location: Erickson Senior Living Erickson Senior Living, headquartered...health care, seeks a passionate, patient-focused physician to provide clinical and operational leadership for Erickson Health Medical Group,… more
- Erickson Senior Living (Houston, TX)
- …a holistic approach, supporting the residents' physical, spiritual, emotional, and clinical needs Following Medicare , state, and federal regulations, company ... Location: Eagle's Trace by Erickson Senior LivingEagle's Trace is a beautiful 70-acre continuing...policies, and procedures and ensuring departmental understanding and compliance in the areas of care provision, documentation, billing… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …organization expert on CMS regulatory changes and will make recommendations to senior management related to proposed changes. Takes the lead for the organization's ... to research complex coding, reimbursement and regulatory requirementsKnowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy,… more
- Erickson Senior Living (Highlands Ranch, CO)
- Location: Wind Crest by Erickson Senior LivingJob Description Wind Crest is a beautiful 84-acre continuing care retirement community located in Highlands Ranch, just ... We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider of senior living and health care with… more
- Sage Health (Mobile, AL)
- …or arrange for all of our patients' healthcare needs, and partner with Medicare Advantage plans that fully cover primary care. Unlike other physician practices, a ... manage patients within a global capitation budget provided by Medicare Advantage plans, our only concern and motivation is...in the country who are building the new standard-bearing senior model for the United States.All applicants are considered… more
- MetroPlus (New York, NY)
- …including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, ... is responsible for the management/oversight of claims quality, claims compliance , training and remediation, user acceptance testing (UAT), claims adjustments,… 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)
- **Role Summary** The Medicare Part C Compliance Senior Manager is responsible for the design, implementation, and ongoing execution of the Medicare ... compliance program while upholding the overall Cigna Compliance Plan. This Senior Manager will ensure...Director of Medicare Business Support and the Medicare Compliance Officer of Part C trends,… 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 has an exciting opportunity**for a Senior Clinical and Corporate Resource & Budget Management Associate (CCT Admin Budget ... **Reg or CII Exempt Staff* **Organization:** **Research and Development - Center for Clinical Trials* **Title:** * Senior Clinical & Corporate Contracts… 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
- Ellis Medicine (Schenectady, NY)
- BASIC FUNCTION: The Clinical Resource Coordinator functions as the clinical nurse manager and oversight Ellis Medical Group Outpatient Practice location(s) (as ... care delivery to ensure efficient and effective patient care. Responsible for compliance with departmental and regulatory standards of care and practice. In… 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
