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Experience in key areas of healthcare payer or provider operations, CMS Risk Adjustment and HCC coding process and quality including Medicare Star Ratings and HEDIS. This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region serving as a liaison between Markets and Provider Performance Enablement teams, Provider Education, and the Risk Adjustment Operations teams.
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Collaborates with the Associate Athletics Director for Student-Athlete Development with NCAA compliance related student-athlete development initiatives, as assigned. Reviews and processes student-athlete name, image and likeness opportunities for NCAA compliance and facilitates education related to personal branding, entrepreneurship and personal finance.
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Excel in developing strong client relationships, drive client dialogue both at CCO/CFO/COO and at CAMLO level, and in shaping and delivering value-led compliance projects. Well versed in global industry leading ecosystem technologies & tools, automation, AI and analytics plus already have a proven track record of implementing digital compliance solutions.
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Conducts periodic facility/branch compliance audits to ensure Evergreen North America/GEM, OSHA, MSHA, EPA, State DEQ and DOT compliance standards. The Branch Safety Manager is responsible for ensuring OSHA, MSHA, DOT, EPA and State DEQ safety compliance requirements for his/ her assigned location's of responsibility.
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Provide expertise to Semafone and our clients in PA DSS & PCI DSS compliance. IVR Vendors / Genesys GVP, Cisco CVP, Nortel MPS, Intervoice Brite, Voice Objects, Voxeo, Avaya, Nuance, etc. Architecture of medium to large scale network and telephony implementations including input to solutions from major vendors (Avaya, Genesys, Cisco, Aspect, Interactive Intelligence, etc.
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A minimum 1+ years of relevant Compliance experience, preferably at an asset management, or experience with financial services or audit experience AML/KYC related experience Knowledge of the federal securities laws, including the Investment Advisers Act of 1940 and the Investment Company Act of 1940 and ERISA. Knowledge of regulatory filings, such as SEC and NFA. The ability to demonstrate strong analytical and problem-solving skills and possess excellent attention to detail.
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Responsible for correcting compliance or safety issues when directed by the Director of Operations, Director of Maintenance, Chief Pilot, Regional Maintenance Director, Director of Safety, Regional Maintenance Manager, or Lead Mechanic.
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Experience advising on compliance issues related to gift card programs, including registration requirements, anti-money laundering (AML) controls, and consumer protection laws. Familiarity with regulatory guidance and industry best practices for gift card compliance, such as the Consumer Financial Protection Bureau (CFPB) regulations and Network Rules.
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Regularly interact with Lennar’s National Environmental Manager and National Director of Environmental Compliance and Safety. Provide oversight and resources to ensure that the divisions within the region implement Lennar’s Environmental Management System (LEMS), which includes stormwater management, air quality compliance, spill prevention control and countermeasures, and environmental due diligence modules.
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Ensure efficient completion and coordination of ongoing department, center, School and program financial accounts (including full-time labor, part-time labor, and non-labor budgets) in compliance with School and University policies and procedures.
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Highly familiar with relevant structural and civil construction laws, codes, regulations, compliance practices, and record-keeping requirements. Experience with discipline-specific design software (i.e., MicroStation, AutoCAD, Civil 3D, ArcGIS, InRoads, Geopak, GeoSlope, ANSYS, STADD, HEC-RAS, HEC-HMS.
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Understanding of technology areas such as Active Directory, DHCP, DNS, Group Policy, DFS and the ability to maintain other Windows core services. Description SAIC is seeking a PC Technician, to support the US Army Corps of Engineers RITS Program.
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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.
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Serves as internal liaison to program staff in their roles as they relate to grant compliance, terms and conditions, procurement, subawarding, etc. Associate Director, Post-Award Administration and Compliance Situated in the Office of Government Sponsored Projects on the Development team, the Assistant Director, Post-Award is responsible for overseeing all operational post-award functions for the Carnegie Museums of Pittsburgh (CMP.
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Whether it's holding a PhD-level deep dive into understanding fairness and underlying bias in machine learning models, debating the merits of a Scandinavian design philosophy in our UI/UX, or writing responses for Medicare rules to influence U.S. health policy, we prioritize sharing our findings across the team and helping each other be successful.
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medicare compliance dfs jobs Title: compliance specialist Company: Metroplus Health Plan in Pittsburgh, PA
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