within the Payment Integrity space. Innovation (R&D): Payment & Reimbursement Policy ownership. Conducts research... medical professionals across the region and conducting innovative research that improve lives around the world...
, terms and reimbursement Maintains a comprehensive knowledge of medical policy as it applies to each payer Engages...Description : We are looking for a Senior Director, Revenue Cycle to join our collaborative team at Memorial Health...
research programs focused on the underlying mechanisms of other serious diseases including programs in Type 1 diabetes, IgA... Nephropathy (IgAN), APOL-1 Mediated Kidney Disease, among others. The Director, Market Access Strategy Lead – AMKD (inaxaplin...
, you will be responsible for the function that identifies, develops, and obtains approval of new medical cost savings opportunities... per week. Primary Responsibilities: Oversee the ideation function that identifies medical cost savings opportunities...
: Implement strategy, policy, and standards to deliver key RDES contracts across the region in the areas of engineering... of initiating, developing and implementing Facilities Master Plans Displays knowledge of Research & Development processes...
– University Medical Center Phoenix has been recognized on the Becker’s Hospital Review 2025 “Great hospitals in America” list.... These hospitals are renowned for clinical excellence, patient safety, innovation efforts, research and education, patient...
, Medical Communications, Medical Compliance, Mentorship, Product Knowledge, Relationship Building, Research and Development... for humanity. Learn more at https://www.jnj.com Job Function: Medical Affairs Group Job Sub Function: Medical Science Liaison...
, and referrals for adults, and/or families with psychiatric illness, substance abuse, and medical illness. Casework or therapy takes... place in the hospital setting. Under the general supervision of the Director of Care Management, the RN Case Manager...
for adults, and/or families with psychiatric illness, substance abuse, and medical illness. Casework or therapy takes place... in the hospital setting. Summary: Under the general supervision of the Director of Care Management, the RN Case Manager...
-based practice to deliver high-quality patient care, contribute to research, and spread innovation beyond Kaiser Permanente... better serve our patients. We participate in research to inform our evidence-based care. Our nurses reflect the rich diversity...
With Developmental Disabilities OPWDD, Medicaid, Medicare, insurance companies, municipalities, Department of Health, school districts... of Physical and Occupational Therapy, Associate Director of Related Services and/or Associate Director of Clinical Services...
claims. Insures department's compliance with all federal regulations and payer policies. Responsible for adherence to policy... and procedures with respect to auditing, billing, coding, and documentation of compliant medical necessity. In depth knowledge...
2+ years of experience with state appeals and denials audits for Medical and Medicaid home care services 2+ years...: Analyze/research/understand data related to how a service/procedure/authorization for denied/modified and appealed services...
2+ years of experience with state appeals and denials audits for Medical and Medicaid home care services 2+ years...: Analyze/research/understand data related to how a service/procedure/authorization for denied/modified and appealed services...
Department of Health and Human Services Exclusions and Medical Vendor Hearings Final Administrative Decisions for the Director...-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help...
and payer policies. Responsible for adherence to policy and procedures with respect to auditing, billing, coding..., and documentation of compliant medical necessity. In depth knowledge of clinical operations and front end patient registration...
and ensures compliance with OTP policy and procedure 21. Insures that Financial Counselors see Medicaid eligible patients. 22... funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical...
This role supports the Foundational Community Supports program, a statewide program offering eligible Medicaid enrollees... a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable...
appropriate Medical Director Chronic Care Coordinator or Case Manager. Documents and uploads all work in the clinical software...). Coordinates and conducts medical record reviews and abstracts data. Records information in the Care Management Platform and hybrid...
expertise with Medicaid/Medi-Cal policy know-how to deliver near-term recoveries and long-term solutions. Responsibilities... to Medicaid/Medi-Cal rules and plan contracts; partner with Compliance/Legal on policy interpretation and provider communications...