- OhioHealth (Columbus, OH)
- …associated with revenue cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject matter expert in the ... This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities....well as the high level strategic purpose. * The Senior Reimbursement Consultant is required to use… more
- Henry Ford Health System (Traverse City, MI)
- …and planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for ... is required. GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400… more
- Baylor Scott & White Health (Nashville, TN)
- **Description - External** **JOB SUMMARY** The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, ... maintenance of, and adherence to established policies and procedures in compliance with federal, state, and local laws and regulations. **SALARY** The… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Policy Consultant Location: Hybrid | Eagan, Minnesota Career Area: ... Blue Cross Blue Shield MN is looking for a Senior Policy Consultant to join our team....adviser for legislative, regulatory, and public policy initiatives impacting Medicare , Medicaid, and government programs. Working closely with internal… more
- Oracle (Austin, TX)
- …and customized solutions for each healthcare payer. An Oracle Health Insurance (OHI) Senior Principal Consultant must be proficient in US healthcare domain ... and contribute to project teams. Requirement analysis, problem-solving, and ensuring compliance with company policies and procedures. Analyze business needs to… more
- Humana (Gainesville, FL)
- …visits up to 40% of the time and is not fully remote. The Senior Stars Improvement, Clinical Professional (RN) is responsible for the development, implementation and ... management oversight of the company's Medicare Stars Program in the Florida region. Ideal candidates...Panhandle. Far north Florida limit would be Jacksonville The Senior Stars Improvement Clinical Professional (RN) + Develops programs… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** This Senior Consultant , Enterprise Rule & Edits position reports to our Enterprise Rules & Edits Manager and has the responsibility for ... active involvement in scoping, project planning, implementation, and stabilization. The Consultant will leverage billing and coding subject matter expertise and… more
- CenterWell (Phoenix, AZ)
- …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
- Humana (Providence, RI)
- …caring community and help us put health first** Humana is seeking a Senior Responsible AI Data Scientist to champion the ethical development of artificial ... through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to… more
- Brockton Hospital (Brockton, MA)
- …and payor contracts. The Manager prepares and as needed, presents reports on compliance activities, trends, and outcomes to senior leadership and governing ... by The Joint Commission (TJC) and the Centers for Medicare and Medicaid Services (CMS). This role involves interpreting...bodies, while also serving as the subject matter expert, consultant , and trainer on all compliance -related activities… more
- CenterWell (Morrow, GA)
- …Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 340 centers across ... care team supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care we want to help those in the communities we… more
- CenterWell (Anderson, SC)
- …Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 340 centers across ... care team supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care we want to help those in the communities we… more
- Highmark Health (Pittsburgh, PA)
- …includes the following lines of business: Medicaid, Federal Segments - Individual, ACA and Senior Markets, Group and Direct Pay Medicare Advantage, Direct Pay ... within Highmark, actively driving and ensuring effective collaboration with senior leaders across all matrixed organizations and corporate functions throughout… 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: ... and certification surveys. Responsible for organizing and supporting ongoing regulatory compliance and for supporting a regulatory compliance committee. The… more
- Baylor Scott & White Health (Irving, TX)
- …INTERNAL CONSULTANT FOR THE INTERPRETATION OF STANDARDS AND FUNCTIONAL COMPLIANCE ASSESSMENT AND PARTICIPATES IN SURVEY RELATED ACTIVITY. SUPPORT AND SUSTAIN ... WITH ACCREDITATION STANDARDS. IDENTIFIES GAPS AND OPPORTUNITIES FOR IMPROVEMENT. REPORTS TO SENIOR LEADERSHIP THE STATUS OF COMPLIANCE WITH STANDARDS. PREPARES… 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. + ... experience in orthopedics, and 2 years of accreditation or certification leadership or senior management experience. Recent experience as a consultant to health… more
- Deloitte (Los Angeles, CA)
- Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk ... on Feb 28, 2026 Work you'll do As a Senior Consultant in our Regulatory, Risk, &...for accuracy of coding and documentation to ensure regulatory compliance + Apply knowledge of medical terminology, disease conditions… more
- Humana (Jefferson City, MO)
- …necessary. Adhere to established guidelines and procedures to ensure consistency and compliance . * Advocate for our agile development approach and our North Star ... with the organization's strategy and long-term goals. * Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that… more
- Trinity Health (Syracuse, NY)
- …Provides leadership and expertise in the areas of accreditation and regulatory compliance , quality and patient safety standards as it relates to associates, staff, ... implementation and evaluation of clinical process related to regulatory compliance . Leverages clinical information technology, process design, change management and… more
- University of Southern California (Los Angeles, CA)
- …interpretation of new or revised standards; Recommends methods/actions to achieve regulatory compliance ; Serves as a consultant for other projects as assigned. ... standards as well as state and federal regulatory agencies, ie Centers for Medicare and Medicaid Services, local State Department of Public Health. This includes… more
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