Medicare Compliance Jobs in Boston

Director of Compliance and Risk Management The candidate ... Insurance Portability and Accountability Act) compliance and that of its supporting ... supporting processes and other healthcare compliance programs; will provide..

Director of Health Care Compliance and Risk Management The candidate ... Management The candidate will manage compliance-related activities and serve as the ... Insurance Portability and Accountability Act) compliance and..

Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..

... Humana Lead Actuary, Risk and Compliance in Boston Massachusetts Description The ... The Lead Actuary, Risk and Compliance is responsible for the overall ... risks. The Actuary, Risk and..

WHS Governance and Compliance Manager The candidate will be responsible for leading a team that interacts with safety and health regulatory agencies. Subject matter expertise in all aspects of regulatory interactions ..

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..

... The Director, Actuarial Risk and Compliance is responsible for the overall ... The Director, Actuarial Risk and Compliance requires an in-depth understanding of ... The Director, Actuarial Risk and..

Job Information Humana HPS Growth Compliance & Risk Management Pharmacy Operations ... substantial. Responsibilities Location: Remote The Compliance & Risk Management Pharmacy Operations ... strategy by supporting risk and compliance..

Job Overview: A law firm in Boston, MA, is seeking an experienced Healthcare Regulatory, Reimbursement, And/Or Fraud And Abuse Associate Attorney to join their team. The ideal candidate will have extensive ..

A law firm based in Boston is seeking a dynamic Healthcare Associate Attorney with a strong interest in technology use in healthcare and a passion for leveraging technology to shape the ..

Senior Compliance Professional- Medicare Sales and Marketing Duties: Develop ... Marketing Duties: Develop and implement compliance policies and procedures. Research compliance issues and recommend changes that ... and recommend changes..

A law firm in Quincy, MA, is seeking a dedicated Personal Injury Protection Attorney to oversee and manage a wide range of tasks related to PIP cases, both in the pre-litigation ..

... best work. SM The Field Based-Compliance Auditor will work with our ... of contracted providers to ensure compliance and adherence to all regulatory ... Audit, as the Field Based..

NABA Senior Compliance Professional Duties: The candidate will ... implementation of Humana’s Oklahoma Medicaid Compliance Program. Serve as the primary ... Care Organization (MCO) communications regarding compliance issues. Ensure that..

Job Information Humana Medicare Appeals and Grievance Medical Director ... relies on fundamentals of CMS Medicare Guidance on following and reviewing ... following and reviewing appeals for Medicare Part C..

Senior Director, Senior Compliance Counsel (Remote) The candidate will be legal Reviewer for Promotional Advertising Review Team. Legal Reviewer for Medical Materials Review Team. Legal advisor in areas of healthcare regulatory ..

Description The Compliance Lead ensures compliance with governmental requirements and works ... include: Responsible for effectiveness of compliance program which includes metrics, reporting, ... process improvements and automation to compliance..

A law firm in Boston, MA is actively seeking a Health Care Associate Attorney to join its Corporate Services Group (CSG). The ideal candidate will simultaneously manage high-level and strategic aspects ..

Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..

Job Information Humana HCS Compliance & Risk Management Quality Audit ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit ... be responsible for executing the Compliance Oversight..

Commercial and Healthcare Compliance Counsel The candidate will provide ... to identify, clarify and inform compliance-based decisions and activities. Own the ... Committee, providing legal advice and compliance guidance on..

... Information Humana Medical Director - Medicare Pharmacy Appeals in Boston Massachusetts ... on clinical background and reviews Medicare drug requests. The Medical director ... based care in accordance with..

Counsel/Senior Counsel, Healthcare Compliance The candidate will take primary ... and enhancing the company’s healthcare compliance program, including establishing policies and ... training, and monitoring to ensure compliance with federal,..