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The Lead Director applies compliance, regulatory, business, analytical and communications skills to support, manage and develop operational solutions to advance Medicare compliant risk adjustment activities for the CVS Accountable Care Organization with national oversight.
$100,000 - $231,500 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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JOB SUMMARYUnder the direction of the Director of Licensing and Regulatory Services, provides legal support to in-house counsel, home health, hospice, home care, and senior living operations as part of a dynamic in-house legal department.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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In cases where Tricare or Medicare/Medicare Advantage is primary or secondary, use scripting to review and deliver appropriate regulatory form (Tricare Rights, Tricare Third Party Liability, and Important Message from Medicare (IMM) form.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Update regulatory fields in demographic data with patient choices on regulatory forms such as Notice of Privacy Practice (NPP), Advanced Directive for Health Care (ADHC), Health Information Exchange (HIE.
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The Senior Financial Analyst will serve as the Solid Organ Transplant primary internal consultant responsible for providing critical analytical support for regulatory and financial implications of the Transplant components of the Medicare Cost Report (MCR.
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Strong interpersonal skills, good verbal and written communication skills and comprehensive knowledge of outpatient coding, CMS HCC, billing, VBC and regulatory requirements. The WellBe care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The incumbent reviews and analyzes key program, regulatory and operational performance indicators for the functional areas reporting to the Assistant Director, Medicare Advantage Operations and makes recommendations to the leadership team on strategies to improve performance.
RemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Applies advanced knowledge of regulatory and accreditation standards such as The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA) to ensure continued compliance in all matters pertaining to professional staff services.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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8+ years professional experience as either a healthcare litigation, regulatory, or transactional associate in a nationally recognized law firm, in-house counsel at a nationally recognized company or organization, or a combination thereof.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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JOB REQUIREMENTSRequired:Master's Degree in Social WorkMaster’s level Licensure with the Behavioral Sciences Regulatory Board as one of the following: Licensed Professional Counselor (KS)Licensed Master Social Worker (KS)Licensed Marriage and Family Therapist (KS)State of Kansas Social Work license requiredAbility to proficiently read and document in electronic medical record required.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Audit operational areas and delegated vendors for compliance and ensure Jefferson Health Plans (JHP) is meeting applicable federal and state laws and regulations, and contractual requirements as set forth by all regulatory entities including but not limited to Pennsylvania State regulatory agencies (DHS, DOH and PID) and Centers for Medicare and Medicaid (CMS.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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This will include but is not limited to, setting up monitoring and adherence protocols that CMS requires for Medicare Advantage clinical programs, as well as identifying, developing, and executing all audit and mental health parity requirements as set for by the Executive Office of Health and Human Services for any Medicaid Accountable Care Organization.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
Full-timeRemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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The Credentialing Coordinator is responsible for maintaining the confidentiality of all Medical Staff related information, organizing and preparing for committee meetings, and ensuring compliance with the Medical Staff Bylaws, accrediting and regulatory agencies (i.e., Joint Commission, Centers for Medicare & Medicaid Services, NCQA) in regard to credentialing while developing and maintaining a working knowledge of the statutes and laws.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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McDermott+Consulting (McDermottPlus) is seeking a Healthcare Economist experienced in developing cost estimates for potential legislation, and analyzing data from the Centers for Medicare & Medicaid Services (CMS) to quantify the financial impacts of regulatory proposals to healthcare providers and other stakeholders.
ExpandApply NowActive JobUpdated 4 days ago
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