CMS Eligibility Systems SME (VLP / RIDP / FDSH)
RICEFW Technologies
Project Overview The purpose of this project is to obtain independent IV&V services to provide objective assessment and oversight of the CMS-required modifications to the Verified Lawful Presence (VLP) and Remote Identity Proofing (RIDP) services. The objective is to ensure that the modifications are delivered in accordance with defined requirements, within scope, on schedule, and in compliance with CMS standards, including validation of requirements traceability, testing activities, and change management processes. Responsibilities Provide input and assessment support for CMS-required modifications to the Verified Lawful Presence (VLP) and Remote Identity Proofing (RIDP) services. Review modifications associated with services provided through the Federal Data Services Hub (FDSH). Assess whether modifications are delivered in accordance with defined requirements, within scope, on schedule, and in compliance with CMS standards. Validate requirements traceability through design, development, and testing activities. Review the quality and completeness of testing activities. Assess change management strategies and execution. Verify that deliverables align with CMS compliance standards. Assess compliance with CMS funding drawdown requirements. Participate in milestone-based and risk-focused IV&V assessments. Review change management processes, risk and issue management activities, and scope and deliverable acceptance processes. Provide targeted, actionable assessment feedback and proposed solutions. Contribute to IV&V Assessment and Milestone Plans, including key success criteria aligned with CMS expectations. Support the completion and development of materials required by CMS to formalize, approve, and finalize the implementation. Engage with OFI Business Technology leadership, MaineIT Vendor Management, and implementation vendor staff as part of the IV&V assessment process. Preferred Relevant Experience Direct experience with one or more of the following: Verified Lawful Presence (VLP), Remote Identity Proofing (RIDP), Federal Data Services Hub (FDSH), Medicaid Eligibility Systems, CMS compliance programs. Key Skills CMS, Medicaid Eligibility Systems, Federal Data Services Hub (FDSH), Verified Lawful Presence (VLP), Remote Identity Proofing (RIDP), CMS Compliance, Eligibility & Enrollment Systems, Federal Verification Services, REST APIs, SOAP APIs, System Integration, Healthcare IT, CMS Certification Support #J-18808-Ljbffr
$33.82 - $41.89 per hour
...compassionate care. We hold accreditation's by CMS and the Joint Commission. The... ...towards the Maine Public Employees Retirement System (MainePERS). Parental leave is one of... ...Leave Act. State employees are eligible for an extensive and highly competitive benefits...CmsHourly payFull timeSeasonal workWork at officeShift workNight shiftWeekend workAfternoon shift$22.33 - $29.03 per hour
...compassionate care. We hold accreditation's by CMS and the Joint Commission. The... ...towards the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.... ...Medical Leave Act. State employees are eligible for an extensive and highly competitive...CmsHourly payFull timeSeasonal workWork at officeShift workWeekend workAfternoon shift$18.67 - $23.23 per hour
...need. Currently, this position is not eligible for visa sponsorship or STEM OPT extensions... ...care. We hold accreditations by CMS and the Joint Commission. The Department... ...towards the Maine Public Employees Retirement System (MainePERS). Parental leave is one of...CmsHourly payFull timeSeasonal workWork at officeImmediate startFlexible hours$109.5k - $164k
...we help patients navigate the health care system and connect them to key support services.... ...weekends a year. Each FT/PT employee is eligible to have up to 6 weekend shifts a year for... ...Center for Medicare and Medicaid Services (CMS) regulations Responsible for ensuring...CmsMinimum wageFull timeWork experience placementLocal areaRemote workRelocation packageAll shiftsShift workNight shiftDay shiftAfternoon shiftWeekday work$22.3 - $35.2 per hour
...prepares and interprets financial reports, oversees financial systems and safeguards the organization's assets. Collections is responsible... ...hourly range: $ 22.30 - $35.20 USD Hourly Bonus eligible: No Benefits: Cardinal Health offers a wide variety of benefits...CmsHourly payTemporary workWork at officeLocal areaImmediate startFlexible hours$223.8k - $313.1k
...including national clinical guidelines, CMS policies and determinations, clinical reference... ..., hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers... ...3,800 - $313,100 per year This job is eligible for a bonus incentive plan. This...CmsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office$110k
...engagement. Knowledge of: Content Management Systems: Intermediate Required Azure Dev Ops for... ...: Intermediate Required Optimizely CMS: Beginner Required BDD & Gherkin: Beginner... ...salary ranges. The position may also be eligible for an annual bonus, commission, and/or long...CmsFull timeWork at office$71.1k - $97.8k
...increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate... ...certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based...CmsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$223.8k - $313.1k
...necessity based on national guidelines, CMS regulations, Humana policies, and recognized... ..., regulatory requirements, or clinical systems. Proficiency with clinical technology... ...3,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive...CmsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work$89.2k - $209.5k
...our clients EHR (Electronic Health Record) system to enable our clients’ to track... ...Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC). The compliance... ...Qualifications: ~ U.S. Citizenship and eligibility for a Federal Security Clearance (flexible...CmsTemporary workImmediate startFlexible hours- ...State of Maine agencies. • Identify, assess, and measure risks in systems, applications, technical environments, networks, and... ...Knowledge of Industry Compliance Standards (e.g., HIPAA, IRS Pub1075, CMS, PCI, CJIS, Social Security Administration) • Ability to...CmsWork at office
- ...Verify and update security documentation reflecting the application/system security design features. Verify that application software/... ...that state governments contend with (e.g., IRS Pub 1075, CMS MARS-E 2.2, PCI, CJIS, Social Security Administration, NACHA); and...CmsWork at office
$55.7k - $75.92k
...Portland Currently, this position is not eligible for visa sponsorship or STEM OPT extensions... ...for Medicare and Medicaid Services’ (“CMS”) Principles of Documentation, if you and... ...towards the Maine Public Employees Retirement System (MainePERS). Parental leave is one of the...CmsFull timeSeasonal workWork at officeShift workNight shift$1,500 per week
...Assistance, Paid Time Off, and much more Growth opportunities performing essential work to support America’s food distribution system Safe and inclusive working environment, including culture of rewards, recognition, and respect Position Purpose: Food and...CmsWeekly payLocal areaImmediate startShift workNight shift$25.39 - $40 per hour
...of medical terminology, medical acronyms, pharmacology, anatomy and physiology and ICD-10-CM/PCS, DRG, and APR-DRG classification systems. Ability to complete and pass internal coding exam. Demonstrated proficiency in using coding software, electronic health records...CmsHourly payShift work- ...situations. Ensures all calls are handled according to contractual service standards and document all cases in the Case Management System (CMS). Performs call follow-up and reporting as assigned. Demonstrates outstanding customer service. Demonstrates exceptional...CmsContract workWork experience placement
$77.9k - $110.07k
...position- Currently, this position is not eligible for visa sponsorship or STEM OPT... ...build a resilient, integrated rural health system that delivers accessible, high-value care... ...RHTP is a grant opportunity administered by CMS that provides $50B to states to transform...CmsFull timeContract workFor contractorsSeasonal workWork at office$32 - $42 per hour
...contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an...CmsHourly payReliefRemote workRelocation packageFlexible hours$21.97 per hour
...record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information...CmsFor contractorsApprenticeshipLocal area$27.02 per hour
...anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits... ...in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for...CmsFor contractorsWork at officeLocal areaRemote workFlexible hours$23 - $26 per hour
...HUD claims timely and accurately according to investor/insurer/CMS guidelines and requirements. Follow up semi-daily on all outstanding... ...action taken, delays, follow-up, and phone conversations in the system notes. Ensure all claim documents are imaged timely. Maintain...CmsTemporary workWork experience placementImmediate startRemote workWork from home$223.8k - $313.1k
...health first The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health, SNF, DME... ..., etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based...CmsFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeMonday to Friday$57.7k
...standards. Maintain current knowledge and adheres to applicable CMS, state, local, and regulatory agency requirements and applicable... ...of healthcare costs and the broader healthcare service delivery system Proficiency in MS Excel and strong analytic skills with...CmsTemporary workFor contractorsWork at officeLocal areaRemote work- ...standards. Ability to assist with maintaining project records, correspondence, and documentation in VA construction management systems. Required Training (to be completed within contract timeframes): OSHA 30-Hour Safety Training VA Cyber Security Awareness...CmsFull timeContract workTemporary workFor contractorsWork experience placementFor subcontractorLocal area
$100k
...Certification Lead to manage end-to-end certification activities, including system implementation support, audits, and ongoing compliance. This... .... Key Responsibilities ~Lead and oversee the project CMS certification lifecycle, including initial certification, audits...CmsRemote work- ...match and immediate vesting Company-issued and company-paid Amex card for travel All travel expenses paid directly by the company Company-paid tax-free Health Savings Account (HSA) CMS's Long-Term Care Basic Training and SMQT certification are required...CmsImmediate start
$44.33 - $68.42 per hour
...performance and compliance with patient safety initiatives, federal, state, and other regulatory bodies such as Joint Commission, OSHA, CMS, DOPL, NFPA, ASME, PVHO, and other unit specific accrediting and certifying bodies. Collaborates with provider leadership to develop...CmsHourly payLocal area- Job Description Job Description Job Title: Construction Manager/Administrator Location: Togus VAMC located at 1 VA Center, Augusta, Maine 04330 Project Name: Electronic Health Record Modernization (EHRM) infrastructure upgrades, Togus, Maine VAMC Client...CmsContract workFor contractorsWork experience placementFor subcontractorRelocation
$160 - $170 per hour
...concise rationales for members and provider determination notifications while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.) Ensure that all aspects of the medical management process are consistent with community standards...CmsHourly payFull timeApprenticeshipPrivate practiceWork at officeLocal areaRemote workWorldwide$227.6k
...Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the...CmsFor contractorsPrivate practiceWork at officeLocal area
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