Healthcare Compliance Specialist - $90K
By Confidential At Florida, United States
Firsthand experience with health plan operation sin utilization management, appeals, grievances, pharmacy and or case management
Minimum three (3) years experience in Health Plan Operations (UM, Rx, Appeals). Managed care experience is required
Experience researching and summarizing applicable regulatory requirements
Ensure product content, workflow and SLAs meet client, regulatory and accreditation requirements
Able to adapt to competing demands, take on new responsibilities, and adjust schedule to meet changing priorities
Working knowledge of CMS processes and regulations
Compliance Analyst - Healthcare
By VillageCare At New York, NY, United States

Compliance Analyst VillageCare is seeking a motivated individual to assume the role of Compliance Analyst. This role will assist in monitoring compliance of the health plan with federal, state and ...