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Compliance oversight for Schedule A request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA. Compliance oversight for Schedule A request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA.
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Ensure Account Manager is performing all tasks as outlined in the MMA Assistant Account Manager or Account Manager Job Description. Assist bSwift team with set-up of client web site as directed by Benefits Operations Manager.
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Assist bSwift team with completion of the bSwift requirements document for any assigned clients that are engaging bSwift as their ben admin and online enrollment technology. Capable of Gathering and Analyzing ICAF, Milliman, Aggregate and DMW reports.
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Under the leadership/approval of the CNO, manages the maintenance of annual Quality Plan, all quality metrics, data abstraction and related reporting. Directs the efforts of performance improvement initiatives to ensure overall compliance with all regulatory standards including national, state, CMS, TJC, DMV and other agencies.
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A Medical Laboratory Scientist (MLS) uses education, experience and analytical judgment to perform the duties of clinical laboratory testing commensurate with the specialty and subspecialty assigned, recognizing technical and process problems and ensuring test systems are functioning properly and within expected parameters before reporting patient test results.
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Familiarity with government/CMS files/reporting is a plus. Recon Analyst I will be responsible for the research and remediation activities required to accurately reconcile/resolve Enrollment and/or Financial discrepancies between HPS data and Exchange/CMS data.
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Reporting Relationship: Reports to Recreation Supervisor - Aquatics. The staff in this division are responsible for the management of facilities such as the Community Center, the Senior Center, and the Outdoor Center, as well as all other City park buildings and recreation facilities such as swimming beaches, sledding hill, amphitheatre and facilities on school property that are operated in partnership with the School District such as the Oak Point Pool and tennis courts at CMS.
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Reporting to the Chief Financial Officer, the Sr. Vice PResident, Managed Care Operations leads the function and will build a team that is responsible for managing our relationships with health plans, including contracting, credentialing and all operational related engagements/communications.
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Collaborate with Compliance and other departments to ensure PHC is appropriately addressing relevant program requirements, i.e., those distributed through ongoing Regulatory Change Management (RCM) memos and the annual CMS Call Letter; coordinate and ensure all necessary CMS and state reporting for the D-SNP program coming from various teams are timely.
$120,686 - $156,735.06 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Function as team member of the Client Services team to ensure superior service to all MMA Clients. Coordinate and/or Deliver Wellness Presentations so that client understands full scope of MMA vendor capabilities.
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Why This Role is Important to UsThe Director, Financial Reporting will help lead the day-to-day accounting operations including overseeing GAAP transactions, internal controls, month-end and year-end closing activities, annual audit, full balance sheet account reconciliations and preparation of subsidiary & consolidated financial statements.
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The RN Case Manager is responsible for identifying said population via provider/clinic referral, utilization management referral, disease registry reporting mechanisms and patient self-referral.
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Understanding of Self-funding, Stoploss, Pharmacy Benefit Management, ERISA guidelines, Affordable Care Act, Section 125, HIPAA and PHI. Oversees annual reporting and filings, ensures accuracy of data and meets appropriate deadlines for 5500 / SAR, Creditable Coverage and Medicare Part D CMS disclosures, CMS demand letters, Healthcare Exchange Appeals, Covered California Appeals, 1095-C, PCORI, Form 720 and Non-Discrimination Testing.
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Provide oversight, support and back up to phlebotomy staff and their responsibilities including but not limited to: learn and utilize materials management ordering system, learn send-out processing and reporting, perform phlebotomy, specimen collection, and patient preparation when necessary.
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O Is actively involved in all aspects of patient safety on the unit including but not limited to; sentinel event monitoring and reporting, root cause analysis, Joint Commission requirements, incident reporting, medication safety policies and procedures.
$37.572 - $56.358Full-timeExpandApply NowActive JobUpdated Yesterday
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