Strategic Regulatory Lead - Medicaid & Health Plans
$67.9k - $199.14kHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement is seeking a Senior Manager in Regulatory Affairs. This remote role will oversee regulatory-related projects, working with clients and stakeholders to ensure compliance with Federal and state mandates impacting CVS. The ideal candidate will have at least 5 years of health plan experience and strong communication skills. The position offers a competitive salary range from $67,900 to $199,144 and a comprehensive benefits package. Join us in making a difference in our clients' outcomes! #J-18808-Ljbffr
$29 - $46.5 per hour
...Careers With Purpose Sanford Health, the largest rural health system in the United... ...Fully remote. Job Summary The Lead UM Specialist serves as the subject matter... ...to learn and apply Sanford Health Plan policies and regulatory requirements consistently and the judgment...RegulatoryHealth InsuranceFull timePart timeRemote workWork from homeShift workDay shift- ...governance, settlement, and the industry’s leading security infrastructure. Home to... ...up. Past experience leading large-scale regulatory or infrastructure projects for a trading... ...reporting requirements) while maintaining a strategic perspective. Experience in both traditional...Regulatory
$67.9k - $199.14k
...Summary As a Senior Manager in the Regulatory Affairs space, you will have... ...potential risks, and lead the drafting of regulatory communications... ...regulatory activities for Medicaid, Exchange, and Commercial... ...help drive a more positive health plan customer experience. Identifying...RegulatoryHealth InsuranceHourly payFull timeTemporary workLocal areaRemote work- ...Description Careers With Purpose Sanford Health is one of the largest and... ...to provide care. Formulates a plan for treatment of the patient and... ...reimbursement of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private...RegulatoryHealth InsuranceFull timeTemporary workPart timeWork from homeShift workNight shift
- ...Overview Sanford Health is one of the largest and fastest-growing not-... ...independently to provide care. Formulates a plan for treatment of the patient and... ...of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private...RegulatoryHealth InsuranceTemporary workShift work
- ...Description Careers With Purpose Sanford Health is one of the largest and... ...care. The NP formulates a plan for treatment of the patient and... ...services. The NP keeps abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private sources...RegulatoryHealth InsuranceFull timeTemporary workPart timeWork from homeMonday to FridayShift workWeekend work
- ...Careers With Purpose Sanford Health, the largest rural health system... ...to provide care. Formulates a plan for treatment of the patient and... ...reimbursement of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private...RegulatoryHealth InsuranceFull timePart timeWork from homeShift workRotating shiftWeekend workAfternoon shift
- ...Careers With Purpose Sanford Health, the largest rural health system... ...to provide care. Formulates a plan for treatment of the patient and... ...reimbursement of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private...RegulatoryHealth InsuranceFull timeTemporary workPart timeReliefShift workWeekend workDay shift
- ...A prominent health system in Sioux Falls seeks a supervisor for its processing and phlebotomy... ...quality laboratory data accuracy, and lead specimen collection and processing. A high... ...a comprehensive benefits package including health and retirement plans. #J-18808-Ljbffr...Health Insurance
- **Sanford Health, the largest rural health system in the United States,... ...independently to provide care. Formulates a plan for treatment of the patient and... ...of services. Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private...RegulatoryHealth InsuranceShift workRotating shiftWeekend workAfternoon shift
- ...emphasizes personal success, respect, health, and wellness. Role Overview The... ...by promoting sound underwriting, regulatory compliance, and alignment with strategic objectives. Responsibilities... ...Traditional and High Deductible health plan options. Generous Paid Time Off plans...RegulatoryHealth InsuranceFull timeMonday to FridayShift work
$46.99k - $122.4k
...Description We're building a world of health around every individual – shaping... ...an audit team member for a health plan that administers benefits to Medicaid members across multiple lines of... ...coding and documentation meet regulatory standards, such as appropriate code...RegulatoryHealth InsuranceFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...emphasizes personal success, respect, health, and wellness, fun and giving back. This... ...with internal teams, and adherence to regulatory standards. Job Duties and... ...underlying business assumptions to inform strategic planning. Monitors the BIN (Bank Identification...RegulatoryHealth InsuranceFull timeWork at officeShift work
$21.5 - $24.74 per hour
...our people. Job Summary The Guest Experience Lead is responsible for ensuring all guests (i.e., customers... ..., wellbeing, and personal growth: Extended health and dental benefits, and mental health plans Paid time off Savings and retirement plan matching...Health InsuranceMinimum wagePart timeShift workNight shiftWeekend workDay shiftAfternoon shiftEarly shift$74.5k - $104.3k
...accuracy and compliance with all regulatory requirements. ~ Develop and... ...claim strategies, action plans, and settlement analyses to move... ...if You Opt Out of Our Health Plan ~ Flexible hybrid work... .... About SFM SFM is the leading workers’ compensation insurer...RegulatoryHealth InsuranceFull timeTemporary workWork at officeLocal areaRemote workHome officeFlexible hours- ...caregivers on medication regimens and disease state management. Document case activities and outcomes in compliance with health plan and regulatory standards. Participate in quality improvement initiatives to reduce hospitalizations and improve health outcomes. What You...RegulatoryHealth InsuranceRemote work
- ...plumbing service operations and lead a team of skilled technicians... ...contract renewals and strategic account management - Build... ...strong safety standards and regulatory compliance Responsibilities... ...experience; benefits include health insurance, dental and vision...RegulatoryHealth InsuranceContract work
$32.5 - $52 per hour
Sanford Health, the largest rural health system in the United States... ...Department Details Summary Lead critical finance initiatives.... ...priorities that align with strategic and financial goals. Job Description... ...and long range financial planning processes across the...Health InsuranceFull timeWork experience placementShift workDay shift$35.5 - $52 per hour
...profit organization, Sanford Health and Good Samaritan Society strive... ...Job Summary We’re seeking a strategic, communicative and... ...Our physical therapy treatment plans require flexibility, collaboration... ...departmental guidelines and meet all regulatory requirements Analyzes and...RegulatoryHealth InsuranceFull timePart timeWork from homeShift work- ...management. A Bachelor's degree in nursing is required, alongside clinical experience and management skills. The role emphasizes strategic oversight, staff support, and ongoing process improvement. A comprehensive benefits package is offered to qualifying employees, making...Health Insurance
- ...appeals and grievances. Apply evidence-based guidelines, plan policies, and regulatory requirements to determine outcomes. Prepare written clinical... ...Us We are a confidential healthcare partner working with health plans and managed care organizations nationwide. Our appeals...RegulatoryHealth InsuranceRemote work
$91k - $147.2k
...Johnson & Johnson,we believe health is everything. Our strength in... ...MTST Global Finance Reporting Lead - Endomech and Energy to be located... ...and Network partners. A strategic business mindset coupled with... ...initiatives against the business plan and suggest mitigating actions...Health InsuranceFull timeTemporary workLocal areaRemote workWorldwide- ...across multiple lines of business. The role involves developing relationships, reviewing compliance policies, and advising clients on regulatory requirements. The ideal candidate has an undergraduate degree and at least five years of compliance experience in the banking...Regulatory
$160k - $170k
...Director, Legal is a senior legal leader responsible for providing strategic and day‐to‐day legal support to Everise's U.S. and global... ...Finance. Support Everise's compliance framework across employment, regulatory, and contractual obligations. Assist with policy development,...RegulatoryHealth InsuranceLocal areaRemote workWork from home$21 - $26 per hour
...to become the trusted authority and leading partner for state departments of insurance... ...and accurately complete state regulatory surplus lines tax filings Ensure... ...initiative and act decisively Perks ~ Health, dental, and vision plans ~ Amazing work-life balance with 4...RegulatoryHealth InsuranceFull timeRemote work- ...accuracy, appropriateness, and clinical necessity. Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations. Communicate approval/... ...cases. Document outcomes in compliance with health plan policies and CMS/state regulations. Support process...RegulatoryHealth InsuranceRemote workWork from homeFlexible hours
- ...Careers With Purpose Sanford Health, the largest rural health system in the United States... ...strategy, goals and market engagement plan. Responsible for ensuring team directly supports... ...focusing on the broader view including strategic growth, best in class operational...Health InsuranceFull timePart timeWork at officeRemote workWork from homeMonday to FridayShift workNight shiftWeekend workDay shift
$46.99k - $122.4k
...Overview We're building a world of health around every individual -... ...support in completing regulatory reporting requirements and contributes... .... Responsibilities include: Leads the management of quality... ...stakeholders Preferred Qualifications Medicaid and/or Medicare managed care...RegulatoryHealth InsuranceHourly payFull timeTemporary workWork experience placementWork at officeLocal area- ...claim pricing based on complex, networked contract rules and regulatory requirements. Design and test complex import/export interfaces... ...and interfacing. 2+ years of working with Tapestry at a Health Plan. Job Details Seniority level: Mid-Senior level Employment type...RegulatoryHealth InsuranceFull timeContract workWork experience placementImmediate startRemote work
$37.5 - $62 per week
...Yesterdayjob requisition id: R-0256696**Sanford Health is one of the largest and fastest-growing... ...highest level of function.**Summary**Plans, organizes and delivers physical therapy... ...departmental guidelines and meet all regulatory requirements. Demonstrates level of treatment...RegulatoryHealth InsuranceReliefShift work3 days per week
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