- Daiichi Sankyo, Inc. (Bernards, NJ)
- …but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and ... Company and/or departmental expectations and goals as identified by senior management.Responsibilities- Lead drafting and negotiating contracts for commercial,… more
- Banner Health (TX)
- …accordingly in a timely fashion. + Working in start-up environment + Medicare Advantage Compliance training, audits, regulations, and manuals. + Reviewing ... knowledge of laws and regulations pertaining to health care, regulatory compliance , Medicare /Medicaid and/or financial reimbursement systems. Must possess strong… more
- Robert Half (Boston, MA)
- …global consulting firm. Where We Need You Protiviti is looking for a Risk and Compliance Senior Consultant to join our growing Healthcare team. What You ... REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S)...healthcare payer regulations and guidance with emphasis on the Medicare Managed Care Manual. + Expertise of core business… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. We are seeking an ... for new and revised positions and department reorganizations, including FLSA compliance , market pricing and internal equity review. Maintains associated processes,… more
- MyFlorida (Tallahassee, FL)
- 68065017 - SENIOR INFO TECH BUSINESS CONSULTANT /FX CERTIFICATION LEAD Date: Dec 16, 2024 The State Personnel System is an E-Verify employer. For more information ... No: 843229 Agency: Agency for Health Care Administration Working Title: 68065017 - SENIOR INFO TECH BUSINESS CONSULTANT /FX CERTIFICATION LEAD Pay Plan: Career… more
- VNS Health (Manhattan, NY)
- …operations and administration of medical management for VNS Health Plans. Assists senior leadership in planning, directing and coordinating all medical and related ... activities. Participates in implementing standards of medical service and advises senior leadership on medical and administrative questions and policies as they… more
- Highmark Health (Columbus, OH)
- …programs and results to key provider partners. + Collaborate with and support the senior Strategic Partners Consultant role as needed + Other duties as assigned ... integration into the overall Enterprise strategy through collaboration with Senior -level internal/external stakeholders. Ensures a high degree of development,… more
- Henry Ford Health System (Detroit, MI)
- GENERAL SUMMARY: The Senior Retirement Consultant (SRC) is a key strategic resource for financial analysis, data integrity, budgeting and accounting information ... the completion of benefit information on Form 990 and Medicare cost reporting. + Provides responses to IRS, PBGC...+ Works closely with HFHS Treasury Department, Audit & Compliance and HFHS Accounting on retirement related distributions and… more
- CenterWell (Dallas, TX)
- …other providers to form a narrow network of quality service focused on senior population health + Responsible for medical interpretation, reviews, and decisions as ... the organization in community and marketing events. + Develop and maintain compliance with the departmental and physician budgets. + Assess, develop and recommend… more
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and ... of Company and/or departmental expectations and goals as identified by senior management. **Responsibilities** - Lead drafting and negotiating contracts for… more
- The Joint Commission (Oakbrook Terrace, IL)
- …from the field, analysis of periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of- compliance reports. 4. ... health care setting(s), and 2 years of accreditation or certification leadership or senior management experience. Recent experience as a consultant to health… more
- CenterWell (Kansas City, MO)
- …other providers to form a narrow network of quality service focused on senior population health + Responsible for medical interpretation, reviews, and decisions as ... in community and marketing events. + Develop and maintain compliance with the departmental and physician budgets. + Assess,...(Customer Service). + Other duties as requested At CenterWell Senior Primary Care, we want to help those in… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Senior Accreditation Specialist is responsible for leading the collaboration with medical staff and leadership to provide a global and ... and works across the hospital to assess, measure, and report ongoing compliance with standards, promote evidence-based best practices, and standardize common survey… more
- Point32Health (MA)
- …within their own model of care, each interdisciplinary team members internally/externally ( Senior Products, Public Plans, Medicare and Commercial). + Meet ... of health (SDOH). + Serves as a resource and consultant to members, their families, providers, and Designated Facilities...productivity, documentation, quality, accreditation, and compliance standards. + Other duties and projects as assigned.… more
- The Joint Commission (Oakbrook Terrace, IL)
- …and inductive reasoning skills to determine health care organizations' degree of compliance with applicable standards and functionality of care delivery systems. + ... dialogues on standards based issues in health care in order to assess compliance and to identify opportunities for improving compliance . + Prepares management… more
