Average salary: $80,000 /yearly
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$223.8k - $313.1k
...A healthcare services provider is looking for a Medical Director to evaluate healthcare services and ensure compliance with CMS regulations. The role entails reviewing clinical cases to determine medical necessity for Medicare and Medicaid members. Candidates must have...CmsRemote workHumana
Augusta, ME18 hours ago$250 - $360 per day
Job Description: We Deliver the Goods: Competitive pay and benefits, including Day 1 Health & Wellness Benefits, Employee Stock Purchase Plan, 401K Employer Matching, Education Assistance, Paid Time Off, and much more Growth opportunities performing essential work...CmsFull timeLocal areaImmediate startShift workNight shiftCore-Mark
Gardiner, ME18 hours ago- ...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
ASM Research, An Accenture Federal Services Company
Augusta, MEa month ago - ...future clients ~ Ability to work within national coalitions to effectively advocate for payment reform,qualityand health equity at CMS/CMMI, within professional organizations and guilds, and across health plan partners. Experience we look for: ~ MD, DOboard certification...CmsWork at officeImmediate startRemote work
Evolent
Augusta, ME1 day ago - ...consistent with LEAPs mission and goals. 2. Assure all supports adhere to Home and Community Based Service as fundamentally designed by CMS. 3. Provide back up support to the Administrator to process payroll. This will include reconciling the timecard against schedule,...CmsHourly payWork at officeLocal area
LEAP Life Enrichment Advancing People
Manchester, ME2 hours agonew - ...relevant experience in lieu of degree. ~2 years' experience with federal data or projects (including but not limited to agencies such as CMS, IRS, DOD, VA, SSA or another federal agency). ~ Must be a US Citizen. Candidates that do not meet the required qualifications...CmsContract workWork at office
ASM Research, An Accenture Federal Services Company
Augusta, ME4 days ago $72.7k
...compliance with business process requirements, regulatory requirements, and accreditation standards. Maintain current knowledge and adhere to CMS, state, local, and regulatory agency requirements and applicable standards of practice for case management, including those published...CmsTemporary workWork at officeLocal areaRemote workHighmark Health
Augusta, ME3 days ago- Company Highmark Inc. Job Summary This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral...CmsWork at officeLocal areaRemote workFlexible hours
Highmark Health
Augusta, ME3 days ago - ...EDUCATION AND LICENSES: High School diploma or G.E.D. required. Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. All appropriate state...CmsImmediate start
Fresenius Medical Care
Augusta, ME3 days ago $15.6 - $19.03 per hour
...for candidates who work well in a team and are enthusiastic and dedicated to providing compassionate care. We hold accreditations by CMS and the Joint Commission. The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience,...CmsHourly payFull timeFor contractorsSeasonal workWork at officeShift workState of Maine
Augusta, ME4 days ago$33.82 - $41.89 per hour
...for candidates who work well in a team and are enthusiastic and dedicated to providing compassionate care. We hold accreditation's by CMS and the Joint Commission. The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience,...CmsHourly payFull timeSeasonal workWork at officeShift workNight shiftWeekend workAfternoon shiftState of Maine
Augusta, ME18 hours ago$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 areaHighmark Health
Augusta, ME1 day ago$223.8k - $313.1k
...Overview Become a part of our caring community and help us put health first The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health, SNF, DME, dual Medicare/Medicaid, Medicaid, IRF and LTACH requests. The Medical Director...CmsFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeMonday to FridayHumana
Augusta, ME2 days ago$126.3k - $173.7k
...C, Ping, or similar. Compliance & Risk Management Skills Familiarity with regulatory and security frameworks, including HIPAA, CMS/Medicare regulations, NIST 800‑63, SOC2, CCPA/GDPR, PCI. Ability to translate regulatory requirements into product features and governance...CmsFull timeTemporary workRemote workHumana
Augusta, ME2 days ago$57.7k
...business process requirements, regulatory requirements and accreditation standards. Maintain current knowledge and adheres to applicable CMS, state, local, and regulatory agency requirements and applicable standards of practice for case management including those published...CmsTemporary workFor contractorsWork at officeLocal areaRemote workHighmark Health
Augusta, ME2 days ago- Construction Administrator (CM-CA) Davenergy Solutions is a rapidly growing, profitable company, headquartered in San Diego, CA. Our employees are the key to maintaining our competitive edge. To attract and retain the best industry talent, Davenergy Solutions shares...CmsFull timeContract workTemporary workFor contractorsWork experience placementFor subcontractorLocal area
DAV Energy Solutions Inc
Augusta, ME18 hours ago $138.9k - $191k
...contracting, including drafting, reviewing, and advising on agreements with delegated entities to ensure compliance with applicable CMS and state requirements; Advising on CMS provider credentialing, and eligibility requirements; Providing legal support for provider quality...CmsFull timeContract workTemporary workApprenticeshipRemote workHumana
Augusta, ME3 days ago$24.29 - $33.84 per hour
...for candidates who work well in a team and are enthusiastic and dedicated to providing compassionate care. We hold accreditation's by CMS and the Joint Commission. The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience,...CmsHourly payFull timeWork experience placementWork at officeRiverview Psychiatric Center
Augusta, ME4 days ago$70k
...and retain information about Carrington, its sales process flow, its products and the specialty lending industry ~ Ability to follow CMS Mortgage Lending loan protocols ~ Excellent verbal, written and communications skills ~ Excellent organizational skills with...CmsBase plus commissionWork experience placementLocal areaCarrington
Augusta, ME4 days ago$223.8k - $313.1k
...context of regulatory compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources Learn Medicaid...CmsFull timeTemporary workApprenticeshipRemote workWeekend workHumana
Augusta, ME3 days ago$27 - $32 per hour
...Management, or Client Management when performance issues occur (vendors inability/failure to comply with investor/insurer procedures and/or CMS requirements). Reviews future and upcoming sales, no less than 5 days prior to scheduling of sale, to ensure all requirements are met...CmsTemporary workWork experience placementImmediate startRemote workWork from homeCarrington
Augusta, ME18 hours ago$20.31 - $27.92 per hour
Join Our Team! Sunbelt Rentals strives to be the customer's first choice in the equipment rental industry. From pumps to scaffolding to general construction tools, we aim to be the only call needed to outfit a job site with the proper equipment. Not only do we offer a ...CmsFull timeTemporary workRemote workFlexible hoursSunbelt Rentals
Augusta, ME1 day ago$223.8k - $313.1k
...Role Overview Provide expert clinical review of inpatient medical records and determine medical necessity based on national guidelines, CMS requirements, Humana policies, and clinical standards. Synthesize complex hospital-based cases and deliver clear, well‑reasoned...CmsFull timeTemporary workApprenticeshipRemote workMonday to FridayFlexible hoursShift workWeekend workHumana
Augusta, ME4 days ago$19.5 - $27 per hour
Job Description: We Deliver the Goods: Competitive pay and benefits, including Day 1 Health & Wellness Benefits, Employee Stock Purchase Plan, 401K Employer Matching, Education Assistance, Paid Time Off, and much more Growth opportunities performing essential work...CmsHourly payPermanent employmentFull timeWork at officeLocal areaShift workCore-Mark
Gardiner, ME18 hours ago$138.9k - $191k
...Ensure products are scalable, operationally viable, and compliant across diverse contract and population needs Anticipate future CMS, Medicare, and market shifts, building adaptable product solutions that remain relevant over time Use your skills to make an...CmsFull timeContract workTemporary workApprenticeshipWork at officeRemote workShift workHumana
Augusta, ME3 days ago$223.8k - $313.1k
...level. All work occurs within a context of regulatory compliance. Diverse resources assist work, including national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. You will learn...CmsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeHumana
Augusta, ME1 day ago$104k - $143k
...external entities (e.g., payers, clearinghouses, vendors) ~ Ensure all solutions support regulatory and contractual requirements (e.g., CMS mandates, HIPAA, interoperability standards, audit readiness) related to medical authorizations ~ Define product outcomes and...CmsFull timeTemporary workApprenticeshipWork experience placementRemote workShift workHumana
Augusta, ME3 days ago- 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
APSI Construction Management
Augusta, ME17 days ago $71.1k - $97.8k
...portfolio of product offerings within the Group Medicare (EGWP) segment and will have ownership of assigned plans from inception to CMS approval. This professional has accountability for the accurate and appropriate documentation of benefit decisions into systems of...CmsFull timeTemporary workFor contractorsRemote workWork from homeHome officeWeekend workHumana
Augusta, ME4 days ago$94.9k - $130.5k
...new data source selection of a complex Test Kit platform that serves members in home options that drive member measure compliance to CMS HEDIS (Healthcare Effectiveness Data and Information Set) Stars measures. This role bridges product ownership, data and software engineering...CmsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeHumana
Augusta, ME18 hours ago
