- Robert Half Legal (Rancho Cucamonga, CA)
- …will be joining a large legal team and become a Managed Care expert ( MediCare ). You will advise on regulatory and compliance issues, and a critical HIPAA ... Healthcare Advisor : Attend meetings with different business units, analyze legal implications, and recommend effective courses of action. The company handles … more
- General Dynamics Information Technology (Fairfax, VA)
- …challenge we can't turn into opportunity. And our work depends on a **Health Policy Advisor ** joining our team to remotely support the Centers for Medicare and ... GDIT, people are our differentiator. As a Health Policy Advisor supporting MATS LFO, you will be trusted to...training for staff and customers. + Understanding Section 508 compliance standards and applying principles to written documents to… more
- Highmark Health (Pittsburgh, PA)
- …in compliance , privacy, government affairs, healthcare operations, risk, audit, or legal functions + 5 years in Healthcare Compliance or Privacy **LICENSES ... responsible for planning, designing, implementing, and maintaining the enGen Compliance Program and its related policies to ensure the... expectations. + Acts as a thought partner and advisor to business leaders to ensure business decisions are… more
- Hartford HealthCare (Hartford, CT)
- …skills * Duties may also include participation on health care committees as the legal advisor * Serve as a subject matter expert, educational resource, and ... Provide legal analysis and advice concerning health care regulatory compliance , physician-hospital relationships, and a wide variety of healthcare business and… more
- Elevance Health (Chicago, IL)
- …and corporate reputation. **How you will make an impact:** + Serve as a trusted advisor and lead legal counsel to the Chief Marketing Office providing strategic ... brands and legal entities in marketing efforts + Partner closely with compliance and other legal subject matter experts to ensure that marketing materials… more
- Stanford Health Care (Palo Alto, CA)
- …to work with the unique and supportive UM team. You can put your knowledge about Medicare , Medicaid, and bedside RN experience to great use in this UM role. If you ... care. Working in collaboration with Physician Advisors, Financial Services, Compliance , Denials Management, Patient Access, Clinical Documentation Integrity, Billing,… more
- Corewell Health (Troy, MI)
- …information, educating and providing information as necessary. Collects and documents Medicare Questionnaire, issue Medicare Inpatient Letter & Medicare ... by Government mandates. Scan appropriate documents. Manage all responsibilities within Compliance guidelines as outlined in the Hospital and Department Compliance… more
- Corewell Health (Trenton, MI)
- …information, educating and providing information as necessary. Collects and documents Medicare Questionnaire, issue Medicare Inpatient Letter & Medicare ... by Government mandates. Scan appropriate documents. Manage all responsibilities within Compliance guidelines as outlined in the Hospital and Department Compliance… more
- Ascendis Pharma (Princeton, NJ)
- …finance, procurement, legal , and contracting partners. Serve as a trusted advisor on contracting and pricing matters, providing guidance and support as needed. ... Operations plays a critical role in driving operational excellence, compliance , and financial performance through effective management of contracting operations.… more
- Virtua Health (Pennsauken, NJ)
- …Audits for government (non-commercial) and commercial payer programs. Manages response process, legal process, and work with other areas for best practice. Evaluate ... administrative support to the Medical Director, Utilization Review and the Physician Advisor team. Coordinates UR appeals process in collaboration with the appeals… more
- Trinity Health (Grand Haven, MI)
- …payment issues. Serves as the liaison between the ministry and the Medicare Beneficiary and Family Centered Care Quality Improvement Organization for patient ... discharge appeals in accordance with Medicare Conditions of Participation and within established timelines. Communicates, pertinent information, including… more
- Trinity Health (Silver Spring, MD)
- …payment issues. Serves as the liaison between the ministry and the Medicare Beneficiary and Family Centered Care Quality Improvement Organization for patient ... discharge appeals in accordance with Medicare Conditions of Participation and within established timelines. Communicates, pertinent information, including… more
- Mount Sinai Health System (New York, NY)
- …+ Identifies and refers potential case management issues to a physician advisor and potential quality issues to QI department. Facilitates appropriate clinical ... the Case Management/Social Work System (ACM/ECIN/CAREPORT). + Ensures that the Medicare IM notice is issued as required. + Ensures cross-departmental consistency… more
- Health First (Viera, FL)
- …with evidence-based standards. 4. Serves as a case management resource expert for compliance with Medicare IM letter, 3008, 1823 PASSR, and DCF mandatory ... legal reporting, etc. 5. Works with the Utilization Department,...collaboratively and maintains active communication with physicians, nursing, physician advisor , and other members of the interdisciplinary care team… more
- Magellan Health Services (Albuquerque, NM)
- …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 ... medical necessity determinations, and conducts peer to peer reviews. + Ensures compliance with case management and disease management programs and clinical goals… more
- Humana (Columbus, OH)
- …data strategies for the organization + Ensuring alignment with business objectives and compliance with legal and regulatory requirements such as GDPR and CCPA ... tools, and digital in CenterWell Pharmacy marketing efforts + Serves as an advisor of the Technology, Measurement, & Optimization Leader in crafting the technology… more
- HCA Healthcare (Houston, TX)
- …illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and ... against established critical pathways. + Reviews and, if necessary, appeals Medicare /Medicaid and Managed Care denials. + Monitors for appropriateness and timeliness… more
- HCA Healthcare (Fort Pierce, FL)
- …illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and ... function as an expert clinical practitioner, case management subject-matter expert, resource, advisor and leader for the members of the case management team.… more