- Robert Half Legal (Alpharetta, GA)
- …role within the healthcare industry. The hire will be responsible for maintaining compliance with Medicaid and HIPAA regulations and overseeing enterprise risk ... within a healthcare or government contracting organization * Oversee the compliance with Medicaid and HIPAA regulations, as well as other applicable federal and… more
- Prime Therapeutics (Columbus, OH)
- … Compliance Officer, Prime's senior leadership team, Executives, Corporate Compliance Committee members, Board of Directors , and other required reporting ... Analyst (Regulatory Intelligence and Assessment) - Remote **Job Description** The Senior Compliance Analyst assists in the implementation of Prime's … more
- Johns Hopkins University (Middle River, MD)
- …analysis, consultation, and reports to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS). Reviews provider ... questions and to clarify various billing concerns. Researches and resolves compliance issues. Maintain strict confidentiality of staff and patient information. Will… more
- Elevance Health (Tampa, FL)
- Job Description **Nurse Medical Management Sr .** **Preferred Location** : Florida. **This position will work 100% remote (with the exception of team meetings which ... miles of one of our Elevance Health PulsePoint locations. **Nurse Medical Management Sr .** Responsible to serves as team lead for nursing staff who collaborate with… more
- Prime Therapeutics (Columbus, OH)
- … Compliance Officer, Prime's senior leadership team, executives, Corporate Compliance Committee members and the Board of Directors ; collaborates across ... or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must...Reports to Sr Professional, Manager, Director or Senior Director in the Compliance department Potential… more
- HCA Healthcare (Nashville, TN)
- …Decision Support, document imaging, computer assisted coding, ICD-10 coding, transcription, speech recognition , NLP, data standards, MPI, ROI, analysis, unbilled ... assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and its programs remain compliant with Centers for Medicare and Medicaid Services (CMS), Organ Procurement and Transplantation Network (OPTN)/United Network for ... to monitor metrics and audit reports to ensure data integrity, policy compliance , and patient safety reporting both internally and externally, to appropriate… more
- Magellan Health Services (Albuquerque, NM)
- …the clinical vision for the health plan(s) for all lines of business ( Medicaid , Medicare and Commercial) and implements and manages programs to support this vision. ... The Senior Medical Director ensures the delivery of appropriate health...care. Monitors and oversees the work of the Medical Directors and Physician Advisors in providing cost-effective and quality… more
- TAD PGS, Inc. (Minden, NV)
- …accurate and timely financial reporting to the executive team and board of directors . + Risk Management: + Identify and mitigate financial risks to the organization. ... + Implement robust internal controls and ensure compliance with all financial regulations and standards. + Operational...agencies. + Maintain strong relationships with the board of directors and finance committee. Basic Hiring Criteria : +… more
- UTMB Health (Galveston, TX)
- …reports to the Chair of Obstetrics and Gynecology with a dotted line to the Sr . VP of Ambulatory Operations of the UTMB Health System the Chair of Pediatrics. The ... **Scope:** **_Has direct oversite over day-to-day RWSP clinical practices operations, compliance , safety, and quality of care and process improvement_** **Essential… more
- DESC (Seattle, WA)
- …Responsibilities:** + In coordination with the Executive Director and other senior directors , assume responsibility for the planning, implementation, operation, ... Senior Director of Clinical Programs Seattle, WA (http://maps.google.com/maps?q=515+Third+Avenue+Seattle+WA+USA+98104) *Clinical Administration Apply Job Type… more
- DESC (Seattle, WA)
- …contract compliance , reports, quality improvement and training and assist Sr . Managers in strengthening their portfolios. + Have working knowledge of state ... Director is a leadership position in DESC's Clinical department, reporting to the Senior Director of Clinical Programs and collaborating with the Director of Mobile… more
- City of New York (New York, NY)
- …continued compliance with accreditation requirements - Collaborate with program directors across the country via American College of Preventive Medicine (ACPM) - ... color. We are looking to recruit a Preventive Medicine Residency Director and Senior Population Health Physician. This role demands a combination of roles, including… more
- Dr. Reddy's Laboratories (Salem, OR)
- …a less traditional background. **Job Description** We are seeking a Director / Senior Director National & Regional Payer Accounts to lead the execution of market ... + Establish strategic relationships with key stakeholders including Medical and Pharmacy Directors within assigned Accounts and educate all on Dr. Reddy's biologic… more
- UTMB Health (Galveston, TX)
- …the Regional Women's Services and Pediatrics (RWSP) Grants and Governance reports to the Sr . VP of Ambulatory Operations of the UTMB Health System. The Director is ... + In collaboration with Director of Clinical Operations and ambulatory directors , determines, monitors and ensures that productivity and utilization goals are… more
- CAMBA (Brooklyn, NY)
- …and procedures applicable to HealthLink program. + Meet and work with the other Senior Program Directors to discuss any findings and implement changes. + Assist ... of medical, psychiatric, behavioral health, social service and housing providers. Funded by Medicaid and pursuant to contracts with two New York State Health Homes,… more
- CVS Health (Sacramento, CA)
- …(eg, specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance , Legal, Accreditation) and clients. The Medical Director (Medical ... to UM transactions and more generally related to CVS Health coverage policies. Medical Directors at CVS Health are encouraged to model the highest levels of clinical… more
- Stanford Health Care (Palo Alto, CA)
- …clinical compliance program that includes but is not limited to ensuring compliance with Medicare and Medicaid billing regulations, fraud and abuse laws, ... of the SHC, SMCH, and other related Boards of Directors , and reports administratively to the Stanford Chief Risk...of conduct related to compliance . + Stewarding compliance committees comprised of senior SHC/SMCH leaders.… more
- Sanofi Group (Cambridge, MA)
- …of pricing innovation and excellence. + Lead and manage 9 high performing pricing Directors and Sr . Directors across Specialty Care [Alliance and ... for all of Sanofi's Pharma business [General Medicines & Specialty Care]. This senior leadership position will manage a talented team of pricing individuals across… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... LinkedIn. **Brief summary of purpose:** Under the general direction of the Senior Internal Audit Manager, theAnalyze and interpret patient medical records pertaining… more