- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Senior Manager Clinical Compliance and Regulatory Accreditation? At HCA Healthcare, you come ... make a difference. We are looking for a dedicated Senior Manager Clinical Compliance and Regulatory Accreditation...Our Talent Acquisition team is reviewing applications for our Sr Manager Clinical Compliance Reg Accreditation opening.… more
- Covenant Health Inc. (Crossville, TN)
- Overview Senior Risk Manager and Regulatory Specialist, Quality Managment Full Time, 80 Hours Per Pay Period, Day Shifts Cumberland Medical Center Overview: ... family-oriented environment focused on exceptional patient care. Position Summary: The Sr . Risk Manager and Regulatory Specialist position is responsible for… more
- University of Colorado (Aurora, CO)
- …Assistant Aurora Wellness Community Health Center (AWCHC) Clinic - Sr . Instructor** **Description** **University of Colorado Anschutz Medical Campus** ... Assistant - Aurora Wellness Community Health Center (AWCHC) Clinic - Sr . Instructor** **Position #00835409: - Requisition #36929:** **Job Summary:** **Examples of… more
- Humana (Phoenix, AZ)
- …part of our caring community and help us put health first** The DSNP Senior Provider Engagement Professional plays a critical role in managing operational ... processes, compliance activities, and provider engagement for the DSNP plans....and communication across internal and external stakeholders. The DSNP Senior Provider Engagement Professional supports positive, long-term… more
- Outreach Development Corporation (Richmond Hill, NY)
- …behavioral health services and training. For more information, please visit www.opiny.org. The Sr . Director of Finance will serve a key member of the financial ... $150,000. Job Scope Working closely with the CFO, the Sr . Director for Finance will provide Financial Leadership and...Assist in leading the annual budgeting process, working with senior management and program leadership to set realistic financial… more
- Covenant Health Inc. (Knoxville, TN)
- …a Forbes "Best Employer" seven times. Position Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for ... and analysis of charges, CPT coding, modifiers and billing processes to ensure compliance with Medicare, Medicaid guidelines and other insurance payors and to… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …with pre-payment process. + Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by Emory Healthcare. + Sr Mgr, Oncology ... Belong. At Emory Healthcare.** At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership… more
- Elevance Health (Norfolk, VA)
- **JR171732 Coding Auditor Sr ** CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists ... of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from… more
- Waystar (Louisville, KY)
- …and work closely with User Experience team and Technology teams. The Sr . Product Manager will coordinate with key stakeholders in sales, marketing, design, ... healthcare industry standards and staying up-to-date on industry changes and compliance issues + Gathering inspiration and ideas by visiting customers regularly… more
- Catholic Health Services (Rockville Centre, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Senior Financial Analyst reports to the Reimbursement team within the Corporate Finance ... for analyzing and optimizing healthcare reimbursement strategies and ensuring compliance with payer regulations and government reimbursement methodologies. This… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** As the Sr Manager, Data Science, you will be a technical and operational leader reporting to the VP of Data Science. Your primary ... the implementation and monitoring of machine learning models, ensuring accuracy, compliance , and reliability in production settings. + Collaborate with product,… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening ... as a key liaison, proactively addressing provider needs, ensuring regulatory compliance , and supporting operational excellence to enhance provider satisfaction and… more
- WellSense (MA)
- …**Participates in community outreach activities and events** + **Ensures quality and compliance with state Medicaid regulations and NCQA requirements** + **Other ... acceptance**_** **Job Summary:** Responsible for managing the assigned territory of professional , institutional and ancillary provider types in order to enhance… more
- Point32Health (MA)
- …Summary** Under the direction of the Director, Clinical Pharmacy Operations, the Senior Manager, Clinical Pharmacy Operations is responsible for managing a team ... cost reduction and administrative simplification for members and providers. Ensures compliance with state and federal regulatory and accreditation requirements in… more
- Humana (Concord, NH)
- …help us put health first** Humana is seeking a strategic and technically adept Senior Product Owner to lead the definition and evolution of AI capabilities within ... transformation goals. This is a high-impact role for a senior level product owner who thrives at the intersection...or in-person-and is deeply committed to employee well-being and professional growth. If this is you, APPLY TODAY! Humana… more
- CareFirst (Baltimore, MD)
- …and Legal departments to resolve complex issues with inter-related legal and Medicaid compliance aspects. **ESSENTIAL FUNCTIONS:** + Direct accountability for ... Office and Legal. Participates in and develops training and education regarding Medicaid Compliance throughout the business unit including the development of… more
- Humana (Juneau, AK)
- …process optimization and state submissions + Process Enhancement: Collaborate with the Senior Professional and Leads and recommend and implement business ... a part of our caring community and help us put health first** The Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the… more
- Healthfirst (NY)
- …key performance indicators (KPIs), productivity, and quality metrics to ensure compliance and optimal performance Partner with Clinical Operations, Quality, ... Compliance , and Provider Relations to ensure alignment and effective...related to utilization management Foster a culture of accountability, professional development, and continuous improvement across all levels of… more
- Waystar (Atlanta, GA)
- …defining market requirements and packaging the features into product releases. This professional self-starter will report to a Director, Product Management and work ... industry standards and staying up-to-date on industry changes and compliance issues + Gathering inspiration and ideas by visiting...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance , Healthcare Medical Claims ... health care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare) + Medical Coding, Compliance , Payment Integrity… more
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