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... for validation and support of healthcare providers (oncologists/hematologists/APP/Pharmacists) on our promotional ... questions, ensuring medical accuracy and compliance with local procedures, ethical and ... Actively assess the medical and..
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... to collect data to support regulatory submissions and for use in ... supply management, budget/contract negotiation and regulatory document managementConducting and/or assisting clinical ... and conduct of study protocolsMonitoring..
... Governance is the combination of Compliance processes established and executed that ... 5 years experience with accrediting compliance for medicare advantage programs. Medicare, ... advantage programs. Medicare, Medicaid, and/or..
... occurs within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and..
Job ID 21000I65Available Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
Boston law firm Krokidas & Bluestein LLP, a premier boutique firm, is seeking experienced counsel to join its thriving health and human services practice. The ideal candidate will have several years ..
Job ID 21000GNSAvailable Openings 1Position Specific Information This position will cover the following clinics in the Springfield, Massachusetts area: Pioneer Valley Dialysis, Western Mass Kidney Center, East Springfield Dialysis, Palmer Dialysis, ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Job ID 21000I8ZAvailable Openings 1Position Specific Information SIGN ON BONUS ELIGIBLE $3000PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... Information Humana Actuary, Risk and Compliance in Boston Massachusetts Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
... Information Humana Medicaid Associate Director, Compliance Nursing in Boston Massachusetts Description ... Massachusetts Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
... occurs within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... monitoring all related behavioral health regulatory..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
... health. Dedicated to simplifying the healthcare experience and helping people navigate ... and helping people navigate their healthcare journey, Author is leveraging digital ... and a passion for the..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
