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This job will deliver value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines.
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Experience in Risk Management Framework (RMF) accreditation and authorization (A&A) processes to include RMF steps 1-4 (categorization, controls selection, control implementation, security assessment) and standard body of evidence (BoE) package development.
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Knowledge of TCRHCC mission, healthcare agencies, hospital self-assessment programs and TJC accreditation requirements, including performance improvement, risk management, infection control, safety, patient safety (and National Patient Safety Goals) and utilization review.
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This Level 5 (Moderate Risk; Public Trust) position requires favorable adjudication of a Minimum Background Investigation (MBI) background investigation before appointment unless a waiver is obtained.
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Establish, monitor, and mature key aspects of the laboratory’s enterprise risk management program efforts, such as developing and coordinating the overall risk management framework and risk assessment for Sandia.
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Responsible for internal/external compliance audits and risk reporting to Senior Management and stakeholders. You have a Bachelor's degree (required), with a Paralegal or Certified Contract Management (CCM) [or other contract management certification], or Juris Doctorate (J.D.), desired.
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Engage business owner to discuss and evaluate corporate safety culture, loss history, risk management controls and maturity of company safety programs. You will assess the risk for various commercial insurance lines of business that can include Property, General Liability, Workers Compensation, Auto/Fleet, Products Liability, Inland Marine and Builders Risk.
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As a Virtual Telesitter at MultiCare you will provide first-line support for at-risk patients. You will maintain patient safety allowing the entire nursing staff to achieve the best of health care management and outcomes.
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Iron Mountain helps lower cost and risk, comply with regulations, recover from disaster, and enable digital and sustainable solutions, whether in information management, digital transformation, secure storage and destruction, data center operations, cloud services, or art storage and logistics.
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Reports risk management issues and internal controls deficiencies identified directly to the Governance, Risk and Compliance Program and provide recommendations for improving the organization's operations, in terms of both efficient and effective performance.
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Ethics & Compliance teams provide coordinated advice and assistance on independence, conflicts, regulatory and risk management issues, as well as dealing with claims, and any queries regarding the organization's ethics.
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A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
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Our core expertise is in Project Controls which includes Scheduling, Cost Controls, Document Management and Controls, Budget tracking and monitoring, Estimating, Risk Analysis, Claims avoidance and Mitigation, Change Management and Earned Value Management.
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Headquartered in Chicago, Illinois, HUB International Limited (HUB) is a leading full-service global insurance broker providing property and casualty, life and health, employee benefits, investment and risk management products and services.
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The APP maintains continuing education credits as prescribed by licensing body and SMG and maintains prescriptive authority; acquires special clinical competencies as required by the group; participates in quality assurance and utilization management activities; and assists with risk management functions.
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