- Eisai, Inc (Boston, MA)
- …consists of: NYC, NJ, RI, CT, MA, NH, ME, VT Job Summary The Senior Manager , Access and Reimbursement will appropriately inform, support and manage regional ... (examples: patient assistance, reimbursement support, distribution and coverage policies). The Senior Manager , Access and Reimbursement is a customer-facing… more
- Senior Living Communities (North Branford, CT)
- …due & send reminders 27. Review Relias and assist with other annual training compliance 28. Attend Senior Leadership Meetings 29. Update training files with team ... Woods, North Branford's premier Retirement Community is now accepting applications for a HR Manager . The ideal candidate will have experience in a wide variety of HR… more
- Senior Living Communities (Winston-Salem, NC)
- …with some outreach directly to prospects, hospitals, physician offices, rehab clinics, senior organizations. We are private pay (not Medicare or Medicaid ... just off of I-40 and Stratford Road. This position is responsible for providing some direct care and compliance support for nursing as well as possibly assisting… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Under direction of the Director of Medicare Compliance , the primary focus areas of this position include development and ... to regulators + Submit materials to regulators + Coordinate attestations from Senior Leadership for submission ** Compliance Regulatory Guidance Distribution** +… more
- The Cigna Group (Nashville, TN)
- **Summary** The Data Governance & Ownership (DG&O) Senior Manager will work with the Provider Data Quality & Accuracy (PDQA) Director to establish the framework ... Functions and Responsibilities** + Coordinate and partner with the key Medicare operations teams, including claims, enrollment, fulfillment, network operations, and… more
- Molina Healthcare (Florence, KY)
- **Job Summary** The Sr . Specialist Member Engagement representative is responsible for monitoring and evaluating member interactions to ensure that the concierge ... address areas of improvement identified during call monitoring. + Ensure Compliance : Ensure that all interactions follow company policies, procedures, and regulatory… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the creation of controls to manage fraud, waste and abuse schemes. + Support the Medicare compliance program by overseeing Medicare fraud waste and abuse ... Prevention (FIP) Unit including management of a team of senior managers, data analysts, fraud investigators, certified coders and...on fraud waste and abuse work, present to the Medicare Compliance Committee and manage requests and… more
- Plante Moran (Columbus, OH)
- Healthcare Reimbursement - Consulting Sr . Manager + Location: United States, Ohio, Columbus + Location: United States, Ohio, Cleveland Make your mark. Our ... senior care healthcare consulting team focuses on our clients'...manage strategic engagements focused on preparation of Medicaid and Medicare cost reports + Prepare, review, and analyze SNF… more
- Commonwealth Care Alliance (Boston, MA)
- … (CHC) preferred + 5 or more years direct work experience inregulatory affairs and/or compliance in Medicare or Medicaid required + 5 or more years of managerial ... Role is Important to Us:** Under direction of the Sr . Director of Regulatory & External Audits, the primary...external regulatory agencies including but limited to Centers for Medicare & Medicaid Services (CMS), Mass Health, Departments of… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Senior Risk Manager Full-Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's top-performing ... by Forbes as a Best Employer. Position Summary: The senior risk manager is responsible for the...Licensure Requirement: Current Tennessee RN license Apply/Share Job Title SR RISK MANAGER ID 4064924 Facility Covenant… more
- University of Miami (Miami, FL)
- …& Operations to work at the UHealth Medical Campus. Core Summary The Senior Manager , Facilities & Operations administers leadership for various projects, ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sr . Manager , Facilities & Operations The department… more
- American Heart Association (Dallas, TX)
- …career. The American Heart Association has an excellent opportunity for a ** Sr . Program Development Manager , Data Solutions, Performance Measures** supporting ... This position works with data quality, use, and other compliance processes. This position is a frequent liaison between...a specific HIT strategic plan supported by volunteers and Senior Management, aligning with Quality and Health IT's overall… more
- Pacificorp (Portland, OR)
- Benefits Administrator (Mid - Sr . Levels) Portland, OR - #112651 **Date:** Aug 20, 2024 **Location:** PORTLAND, OR, US, 97232 **Company:** PacifiCorp **JOIN OUR ... insurance approvals. Ensure enrollment and mid-year changes are done within compliance and departmental deadlines. + Establish and maintain confidential benefit… more
- Healthfirst (NY)
- …Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. ** Compliance & Regulatory Responsibilities:** Noted ... on all aspects related to one or more specific Medicare performance areas such as Risk Score Accuracy, ...Medicare performance areas such as Risk Score Accuracy, Medicare Clinical Programming and Operations, Provider Performance, Medical and… more
- Molina Healthcare (South Florida, FL)
- …metrics/Risk Adjustment will receive first consideration.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions / QI Compliance ... more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-, program-, and… more
- The Cigna Group (Springfield, IL)
- The **Regional Medicare ** **Provider Contracting Senior Manager - Midwest** serves as an integral member of the Network Development and Solutions Team and ... reports to the Medicare Provider Contracting Regional Vice President. This role is...local market provider engagement, claims operations, clinical, Legal, analytics, compliance , sales, and provider relations. + Manages strategic positioning… more
- CareOregon (Portland, OR)
- Job Title Sr Accountant Exemption Status Exempt Department Finance Manager Title Accounting Supervisor - Ops Direct Reports n/a Requisition # 24549 Pay and ... Portland, Oregon or SW Washington. Job Summary This position performs senior level accounting functions for the organization. Primary responsibilities include… more
- The Cigna Group (St. Louis, MO)
- …and other day of choosing)** **Summary:** The Stars and Risk Adjustment Operations Senior Advisor will report to the Stars and Risk Adjustment Managing Director and ... actions into a synthesized set of business updates and strategies for a senior executive-level audience. Ideally this high-potential candidate uses this role as a… more
- Access Dubuque (Dubuque, IA)
- …department compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or ... Staff Accountant Sr -Financial Plan **UnityPoint Health Finley Hospital** 1 Positions...Overview** **Overview** Reporting to the VNA Director, the VNA Senior Staff Accountant provides all financial oversight of VNA… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **38319BR** **Extended Job Title:** Sr Med Billing Assoc **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Employees in this position ... to process patient and/or insurance refunds for the Institutional Office of Compliance and/or Audit Services timely and accurately as defined by their audit… more
