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Molina Healthcare
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Georgetown, Kentucky
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Counsel, and Medical Officers in order to achieve and maintain appropriate anti-fraud oversight ... billing patterns through utilization review.
Prepares appropriate FWA referrals to regulatory
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Molina Healthcare
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Georgetown, Kentucky
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utilization management, ensuring compliance with regulatory and accrediting standards.
Manages and
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Molina Healthcare
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Georgetown, Kentucky
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JOB DESCRIPTION
Job Summary
Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit
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Molina Healthcare
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Georgetown, Kentucky
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JOB DESCRIPTION
Job Summary
Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit
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Molina Healthcare
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Georgetown, Kentucky
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position is responsible for creating regulatory reports specific to the SIU in support of contractual ... regulatory rules, contracts, and other guidance to assess compliance and support building regulatory
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Walgreens
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GEORGETOWN, Kentucky
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of prescribed medications within regulatory guidelines, company policies and procedures. Supports the
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Molina Healthcare
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Georgetown, Kentucky
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claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit
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Ryder System
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Georgetown, Kentucky
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and counsel as well as recognizing team and individual successes
Cultivate team spirit with a
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Molina Healthcare
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Georgetown, Kentucky
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.
Writes narrative reports to interpret regulatory specifications, explain programs and results of programs
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Molina Healthcare
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Georgetown, Kentucky
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regulatory audits by performing file review and preparation.
Participates in regulatory audits as
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Molina Healthcare
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Georgetown, Kentucky
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management.
Maintains program compliance with respective government and regulatory agencies
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LifePoint Health
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Georgetown, Kentucky
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procedures as needed to stay current with the regulatory requirements.• Supervises the administrative
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LifePoint Health
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Georgetown, Kentucky
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.Monitors departmental budgets, regulatory compliance, departmental contracts, and vendor relations.Creates
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Molina Healthcare
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Georgetown, Kentucky
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eligibility issue trends with Management.
Manages high volumes of tasks to support regulatory ... enrollment transactions.
Prioritizes daily, weekly and monthly job tasks to support regulatory
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Molina Healthcare
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Georgetown, Kentucky
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responsible for the analysis, design, and implementation of IT Healthcare Compliance & regulatory systems to ... systems and processes to support regulatory compliance.
Coordinate with developers and IT teams to
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Molina Healthcare
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Georgetown, Kentucky
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Molina Healthcare provider network consists of providers that meet all regulatory and risk management ... required verifications as outlined in Molina policies/procedures and regulatory requirements, while meeting
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Molina Healthcare
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Georgetown, Kentucky
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Molina Healthcare provider network consists of providers that meet all regulatory and risk management ... required verifications as outlined in Molina policies/procedures and regulatory requirements, while meeting
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Molina Healthcare
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Georgetown, Kentucky
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regulatory requirements.
Identifies new opportunities for process development.
Develops and
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LifePoint Health
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Georgetown, Kentucky
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, regulatory compliance, and policy to conduct medical necessity reviews.
Job Requirements
Minimum
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Molina Healthcare
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Georgetown, Kentucky
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.
Reviews Medical Economics analyst work products to ensure accuracy and clarity.
Reviews regulatory
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Molina Healthcare
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Georgetown, Kentucky
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requests from regulatory agencies, contracting agencies, or other external organizations.
Track
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LifePoint Health
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Georgetown, Kentucky
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About Us
Lifepoint Health’s Central Kentucky market is comprised of four acute care, community-base
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Walmart
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Georgetown, Kentucky
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Position Summary...
What you'll do...
Behind the counter? Yes. Behind the scenes? Hard
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Molina Healthcare
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Georgetown, Kentucky
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bids, mergers, and regulatory reporting requiring collaboration with corporate and health plan senior
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Molina Healthcare
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Georgetown, Kentucky
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, maintains submission schedule, central documentation of market nuances, compliance, and regulatory
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Molina Healthcare
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Georgetown, Kentucky
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provider database, compliance with regulatory/accreditation requirements, and Network Management business
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Molina Healthcare
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Georgetown, Kentucky
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Job Description
Job Summary
The Solution Architect, Advanced Provider Data Management is responsible for understanding regulatory complexities, business challenges, and organizational
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Penske
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Georgetown, Kentucky
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processes, and behaviors
• Ensure compliance with all applicable regulatory agencies and company
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Molina Healthcare
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Georgetown, Kentucky
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and other Molina departments as needed.
Writes narrative reports to interpret regulatory
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Molina Healthcare
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Georgetown, Kentucky
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and applicable Federal and State regulatory requirements and guidelines, knowledge of Molina policies
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