... Medicare and Medicaid programs * Providing comprehensive training for systems related to the ... management process and providing on-going support as it relates to the program integrity
... Medicare and Medicaid programs * Providing comprehensive training for systems related to the ... management process and providing on-going support as it relates to the program integrity
... Medicare and Medicaid programs * Providing comprehensive training for systems related to the ... management process and providing on-going support as it relates to the program integrity
... Medicare and Medicaid programs * Providing comprehensive training for systems related to the ... management process and providing on-going support as it relates to the program integrity
Medicare Sales Agent
Indianapolis, IN · On-site
Star Benefit Associates, an Integrity company, was founded with a focus on Small Group products ... Manage a high volume of client reviews and enrollments during the peak season from October 15 to ...
Medicare Sales Agent
Indianapolis, IN · On-site
Star Benefit Associates, an Integrity company, was founded with a focus on Small Group products ... Manage a high volume of client reviews and enrollments during the peak season from October 15 to ...
Star Benefit Associates, an Integrity company, was founded with a focus on Small Group products ... Manage a high volume of client reviews and enrollments during the peak season from October 15 to ...
Star Benefit Associates, an Integrity company, was founded with a focus on Small Group products ... Manage a high volume of client reviews and enrollments during the peak season from October 15 to ...
Reimbursement Manager
Hammond, IN · On-site
... programs. This role is responsible for ensuring all annual Medicare, Medicaid, and state cost ... financial integrity. 3. Strategic Forecasting, Project Management & Administration (20% of Time)
Quick apply
Reimbursement Manager
Hammond, IN · On-site
... programs. This role is responsible for ensuring all annual Medicare, Medicaid, and state cost ... financial integrity. 3. Strategic Forecasting, Project Management & Administration (20% of Time)
Who is currently in Medicare/ Medicaid! Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience! Who holds 2 years experience with Medicare systems and ...
Who is currently in Medicare/ Medicaid! Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience! Who holds 2 years experience with Medicare systems and ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · On-site
$52K - $69K/yr
Must be able to manage multiple deadlines and prioritize assignments * Proficient use of applicable ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
New
Staff Accountant
Indianapolis, IN · On-site
$52K - $69K/yr
Must be able to manage multiple deadlines and prioritize assignments * Proficient use of applicable ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
New
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Staff Accountant
Indianapolis, IN · Hybrid
$52K - $69K/yr
... management and consulting services to government-sponsored health care ... programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid ...
Clinical Program Manager
Indianapolis, IN · On-site
The Program Manager is responsible for conducting clinical audits of the providers to ensure ... Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care ...
Clinical Program Manager
Indianapolis, IN · On-site
The Program Manager is responsible for conducting clinical audits of the providers to ensure ... Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care ...
... integrity, accountability, and high-quality patient care. This is a hybrid position with a ... programs and regulatory adherence * Ensure compliance with Medicare, Medicaid, state, and payer ...
... integrity, accountability, and high-quality patient care. This is a hybrid position with a ... programs and regulatory adherence * Ensure compliance with Medicare, Medicaid, state, and payer ...
Clinical Program Manager
Indianapolis, IN · On-site
The Program Manager is responsible for conducting clinical audits of the providers to ensure ... Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care ...
Clinical Program Manager
Indianapolis, IN · On-site
The Program Manager is responsible for conducting clinical audits of the providers to ensure ... Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care ...
... integrity, accountability, and high-quality patient care. This is a hybrid position with a ... programs and regulatory adherence * Ensure compliance with Medicare, Medicaid, state, and payer ...
... integrity, accountability, and high-quality patient care. This is a hybrid position with a ... programs and regulatory adherence * Ensure compliance with Medicare, Medicaid, state, and payer ...
Business Office Manager
Indianapolis, IN · On-site
Experience in a Long-term Care or Healthcare setting w/Medicare and Medicaid strongly preferred ... Continued education opportunities with company-sponsored scholarship programs * Tuition ...
Business Office Manager
Indianapolis, IN · On-site
Experience in a Long-term Care or Healthcare setting w/Medicare and Medicaid strongly preferred ... Continued education opportunities with company-sponsored scholarship programs * Tuition ...
Business Office Manager
Indianapolis, IN · On-site
Experience in a long-term care or healthcare setting with Medicare and Medicaid strongly preferred ... Continued education opportunities with company-sponsored scholarship programs * Tuition ...
Business Office Manager
Indianapolis, IN · On-site
Experience in a long-term care or healthcare setting with Medicare and Medicaid strongly preferred ... Continued education opportunities with company-sponsored scholarship programs * Tuition ...
... Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or ... This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging ...
... Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or ... This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging ...
... Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or ... This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging ...
... Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or ... This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging ...
... Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or ... This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging ...
... Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or ... This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging ...
Medicare Medicaid Program Integrity Manager information
What does a Medicare Medicaid Program Integrity Manager do?
A Medicare Medicaid Program Integrity Manager is responsible for overseeing efforts to prevent, detect, and address fraud, waste, and abuse within Medicare and Medicaid programs. They develop and manage compliance strategies, conduct audits and investigations, and ensure that healthcare providers and beneficiaries follow federal and state regulations. Their work helps protect public funds and maintain the integrity of government healthcare programs.
What are the key skills and qualifications needed to thrive as a Medicare Medicaid Program Integrity Manager?
To thrive as a Medicare Medicaid Program Integrity Manager, you need expertise in healthcare compliance, fraud detection, regulatory policy, and a bachelor's degree in healthcare administration or a related field. Familiarity with data analytics tools, case management systems, and regulatory databases such as CMS is typically required, along with certifications like Certified Professional in Healthcare Quality (CPHQ) or Certified Fraud Examiner (CFE). Strong analytical thinking, leadership, and effective communication skills are essential for coordinating investigations and collaborating with stakeholders. These skills and qualifications are crucial for upholding program integrity, minimizing fraud and abuse, and ensuring adherence to government healthcare regulations.
How does a Medicare Medicaid Program Integrity Manager typically collaborate with compliance teams and federal auditors?
A Medicare Medicaid Program Integrity Manager regularly works alongside compliance teams to develop and implement processes that detect and prevent fraud, waste, and abuse in government healthcare programs. They also serve as a key liaison during audits and investigations conducted by federal agencies, ensuring that all requested documentation is accurate and submitted promptly. Frequent communication and coordination with both internal teams and external auditors are essential, as these partnerships help maintain program integrity and regulatory compliance.
What are popular job titles related to Medicare Medicaid Program Integrity Manager jobs in Indiana?
For Medicare Medicaid Program Integrity Manager jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Medicare Medicaid Program Integrity Manager jobs in Indiana look for?
The top searched job categories for Medicare Medicaid Program Integrity Manager jobs in Indiana are:
Registered Nurse (RN), Regional Assessment and Reimbursement Coordinator
Indianapolis, IN
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 21 days ago
Communicare Health Services rating
6.1
Based on 158 frontline employees who took The Breakroom Quiz
731st of 898 rated healthcare providers
Job description
Job Address:
8275 Allison Pointe Trail Suite 370 Indianapolis, IN 46250CommuniCare Health Servicesis currently looking to fill the key position ofRN Regional Assessment and Reimbursement Coordinator in the Indianapolis, Indiana area.
PURPOSE/BELIEF STATEMENT
As the Regional Assessment and Reimbursement Coordinator, you will provide consultation, guidance, support, research, analysis, training, and expertise to attain business goals and quality outcomes in the delivery of care and services to our patients regardless of payer source. You will be responsible for multiple centers to evaluate and provide education, intervention, and support for the Resident Assessment Instrument (RAI) process, Federal and State regulations regarding reimbursement systems, and special contract reimbursement systems.
JOB RESPONSIBILITIES
- Demonstrating knowledge of and interpreting applicable policies and procedures, State and Federal regulations, and interpreting changes to federal Medicare and Medicaid programs
- Providing comprehensive training for systems related to the patient assessment instrument, clinical software, Medicare reimbursement, Medicare coverage/eligibility requirements, State Medicaid reimbursement systems, and special contract systems
- Monitoring and supporting center reimbursement and clinical services
- Providing direction for the implementation of the case management process and providing on-going support as it relates to the program integrity
- Monitoring RAI process for accuracy and completeness to assure accurate, comprehensive patient assessment and reimbursement potential is reflected by medical record review, discussion, recommendation, documentation, and reporting
- Maintaining role of RN Resident Assessment Coordinator (RAC) when needed
- Recruiting and orienting new RACs as needed
- Establishing rapport and trust with regional and center teams, communicating concerns appropriately
POSITION REQUIREMENTS
- Registered Nurse license in primary state of residence
- Minimum of three (3) years of experience as a trainer in Medicare, Medicaid, RAI, and contract reimbursement systems preferred
- Multi-facility management experience preferred
Benefits
As a CommuniCare employee you will enjoy competitive wages and PTO plans in a great team atmosphere! We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.If you meet the requirements below for Mobile MDS Coordinator, and are interested in this opportunity, please respond to this ad with your letter of interest for immediate consideration.
About Us
A family-owned company, we have grown to become one of the nation's largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another.
What Communicare Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About CommuniCare Health Services
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Cincinnati, OH, US