Browse
···
Log in / Register

Commercial Regulatory Guidance Specialist NYC

Negotiable Salary

Athari

New York, NY, USA

Favourites
Share

Description

The Commercial Compliance Specialist reports to the Director of Regulatory Compliance. The position will support the oversight and management of QHP, EP, CHP and large group products. This position requires knowledge of healthcare regulations and policies, and the ability to interpret and apply them in a complex and dynamic environment. The Commercial Compliance Specialist will collaborate closely with internal stakeholders to implement policies and procedures, conduct compliance reviews, and provide guidance on compliance matters. Job Description Ensure compliance with Affordable Care Act, CMS guidelines, and state-specific regulations for marketplace and large group products. Provide guidance on compliance matters to internal stakeholders, including senior management, sales and marketing, and product development teams. Conduct compliance reviews and audits to identify and address compliance issues. Identify compliance risks and contribute to the development of the annual compliance risk assessment and work plan. Conduct auditing and monitoring activities as outlined in the compliance work plan. Stay up to date on changes in regulations and policies affecting marketplace and commercial products. Communicate compliance issues and developments to internal stakeholders, including senior management, sales and marketing, and product development teams.  Upon identification of non-compliance, provide support to business areas in conducting a root cause analysis and corrective actions, including guidance on methodology, identification of relevant regulatory requirements and any regulatory compliance context and compliance review.  Plays a critical role in driving the progress for corrective actions throughout the organization. Ensures implementation of new policy guidance and regulatory provisions.  Review supporting implementations, demonstrating compliance with new regulatory provisions. Review operational policies and procedures to ensure adherence to regulatory requirements. Provides support for full operational external regulatory audits. Ensures timely implementation of corrective actions from state regulatory audits. Provides updates and data for the materials prepared for both the Internal Compliance Committee Meetings and Audit and Compliance Subcommittee of the Board of Directors.  Coordinates the support for business areas in creating, updating, and monitoring metrics to assess continued compliance with regulatory requirements. Other duties as assigned or requested. Requirements Bachelor’s degree; and At least 3 years of managed care experience; or A satisfactory combination of education, experience, and training CHC, CCEP Knowledge of healthcare regulations and policies, including Affordable Care Act, CMS guidelines, and state-specific regulations for government, individual and group insurance policies. High-level of skill in leading interdepartmental and cross-functional workgroups; and managing multiple projects to ensure corporate deadlines and objectives are met.  Ability to operationalize complex regulatory provisions, laws, and statutes.  Excellent oral, written, and presentation skills, as well as conceptual and analytic skills are necessary to review and articulate corporate objectives and Federal regulations across all relevant audiences. The utmost integrity in the discreet and confidential handling of confidential materials is necessary

Source:  workable View Original Post

Location
New York, NY, USA
Show Map

workable

You may also like

Heartstrings Pet Hospice, In-Home Euthanasia & Aftercare
Full Time Veterinarian - Ann Arbor, MI (JUL2)
Ann Arbor, MI, USA
Experience Fulfillment at Heartstrings Pet Hospice! Join Our Team as an In-Home Veterinarian in Ann Arbor. Are you looking for a refreshing change from in-clinic practice? Do you want to reconnect with pet families and provide the compassionate care you've always envisioned, with generous appointment times and minimal administrative duties? If you consider yourself a compassionate and empathetic individual, we would love to have you join us! At Heartstrings Pet Hospice, our mission is to support pets and their families during one of life's most challenging moments by helping pets pass peacefully in the comfort of their own home. Established and owned by veterinarians, we understand that pets are beloved family members. We prioritize building deep and meaningful connections with pet families, colleagues, and the community. Join our team and become part of a nurturing and supportive environment where you can thrive both professionally and personally. Discover a Unique and Rewarding Career as a Veterinarian Make a greater impact with an average of 3-4 appointments per day Receive gratitude and appreciation in every appointment Embrace the freedom of a mobile practice without being tied to a clinic Benefit from comprehensive training and ongoing mentorship Achieve an actual work-life balance Enjoy schedule flexibility, with 2-5 day-per-week work options, with most appointments occurring between 9 am and 5 pm Participate in Team Building and Retreat Activities Requirements Veterinarian Core Responsibilities Provide in-home euthanasia and hospice care for geriatric and terminally ill pets Guide families in making end-of-life decisions for their pets Build relationships with local veterinary clinics, serving as an extension of their excellent care Qualifications Doctor of Veterinary Medicine (DVM/VMD/BVMS) 1+ year(s) experience as a practicing veterinarian Possess a valid driver's license Able to lift up to 50 lbs. unassisted and up to 100 lbs. assisted Capable of walking, kneeling, bending, crouching, crawling, stooping, standing, and reaching consistently during the workday Comfortable with prolonged periods of driving Demonstrated manual dexterity, fine motor skills, and the ability to maintain steady hands while using medical tools Benefits Benefits Range of health insurance plans, including vision and dental, with options for both individual and family coverage Mileage Reimbursement Quarterly Productivity Bonuses Retirement Plan (Traditional 401k with up to 3% match and Roth 401k) Life Insurance (Basic, Voluntary, and AD&D) Paid Time Off/Bereavement Leave/Paid Parental Leave Professional Training and Development Pet Insurance
Negotiable Salary
Navion Senior Solutions
Certified Nursing Assistant (Full-Time)(3rd shift) - Fountains in Cartersville
Cartersville, GA, USA
The Fountains in Cartersville, a community of Navion Senior Living located in Cartersville, GA, is seeking Certified Nursing Assistants (CNA) who can provide outstanding resident care and physical support on a daily basis in our residents' home. A CNA will provide compassionate care and assistance with activities of daily living. The ideal candidate comes with a big heart as they support and respond to the residents' emotional and physical needs. This is a Full-Time opportunity for someone to join a great team on 3rd shift in supporting our residents! Candidates must be available to work rotating weekends and holidays! The Fountains in Cartersville has partnered with Tapcheck, revolutionizing the way team members get paid! Join our amazing team and be part of a groundbreaking mobile app that allows team members to access their earned wages instantly. Say goodbye to waiting for payday and the stress of financial instability. With Tapcheck, we believe in empowering team members and giving them more control over their finances. With our innovative technology and user-friendly interface, we are reshaping the world of payroll! Responsibilities Demonstrates a positive working relationship with residents, family members and staff Maintains confidentiality of residents’ information in compliance with HIPAA guidelines Assist with daily living activities to make sure the patient is taken care of. This includes turning and ambulating patients and delivering food and beverages to patients throughout the day Help patients with personal hygiene, such as providing bedpans and helping them bathe Provide adjunct patient care as needed. This can include delivering ice packs and dressings to help relieve pain while in therapy or baths for soothing purposes after their session has ended Closely monitor and record food intake, as well as urinary and fecal output, to be shared with key medical and nursing staff Process a wide range of information from other professionals and work with physicians, caregivers, and nurses Infection Control precautions and practices are utilized with all activities. Demonstrates knowledge of fire and emergency procedures. Reports all safety violations. Requirements Passion for the senior population High School diploma or GED State Certified Nursing Assistant Certification Current CPR Certification (American Heart Association) preferred Basic computer skills The ability to think and work independently, with direction from a team leader or manager, while maintaining efficient and consistent communications at all times Must also have excellent oral communication skills when speaking with other health professionals in the presence of residents (i.e. “bedside manner”) Can endure high-pressure situations in a fast-paced, time-sensitive environment and keep a calm, professional demeanor throughout Benefits Health Care Plan (Medical, Dental & Vision) Retirement Plan (401k) PTO for full time positions Short & Long Term Disability Insurance Life Insurance Career Advancement Opportunities #RNW
Negotiable Salary
Boca Recovery Center
Registered Nurse
Huntington, IN 46750, USA
Staff Nurse Boca Recovery Center Website Location: On Site – Huntington, Indiana Department: Medical Services Shift - Full time Night shift Reports to: DON Salary: Competitive, based on licensure and experience About Boca Recovery Center Founded in 2016, Boca Recovery Center is a nationally recognized addiction treatment provider specializing in substance use disorders and co-occurring mental health conditions. With locations in Florida, New Jersey, Indiana, and Massachusetts; we deliver evidence-based clinical care in a supportive, structured environment. Our team is committed to providing trauma-informed, client-centered services that promote lasting recovery. Position Overview We are seeking a dedicated and detail-oriented Staff Nurse to join our team in Bloomington, Indiana. This role is integral to supporting clients’ medical needs throughout their recovery journey. The Staff Nurse will manage infection control, conduct patient assessments, handle medical documentation, and facilitate health-related group sessions, all while ensuring the highest standards of care and compliance are maintained. Key Responsibilities Ensure infection control practices and reporting procedures are in place. Conduct urinalysis toxicology data analysis. Enter orders for all clients in the facility as instructed. Triage medical issues and perform thorough patient assessments. Document client symptoms and health-related complaints in the EMR. Maintain communication with scheduling coordinators and doctors. Lead HIV/Hepatitis and Nutrition groups and complete associated documentation. Attend all scheduled staff meetings. Maintain clear, written logs of client activities. Report significant questions, concerns, and complaints to counselors or administrative staff. Complete all required paperwork including medical logs, shift reports, and MORs. Maintain prompt and regular attendance. Assist in the medical training of BHTs as needed. Be available for overtime if required. Perform other duties as assigned by senior management. Qualifications/Required Experience Licensed Nurse in the state of Indiana. CPR Certification required. Several years of experience in a substance abuse or psychiatric setting. Strong verbal and written communication skills. Ability to work 12-hour shifts and must be available to work weekends and have schedule flexibility. Education & Licensure Licensed Practical Nurse (LPN) or Registered Nurse (RN) credential in Indiana required. CPR certification required and must be maintained during employment. Requirements Licensed Nurse in Indiana CPR Certified Multiple years of experience in a substance abuse or psychiatric environment Strong communication skills required (verbal and written) Ability to work 12-hour shifts AND MUST BE AVAILABLE TO WORK WEEKENDS/ FLEX Benefits Boca Recovery Center offers a comprehensive benefits package, including: Health Insurance Retirement Plans Disability Coverage Paid Time Off Continuing Education & Professional Development Opportunities Join Boca Recovery Center and make a meaningful impact through expert, compassionate care in a mission-driven environment focused on recovery and wellness.
Negotiable Salary
Greenlife Healthcare Staffing
Physician Assistant
New York, NY, USA
Physician Assistant Housecalls - North Manhattan, Bronx, & Queens, NY Minimum of 1 year experience in Primary Care Greenlife Healthcare Staffing is currently seeking a Physician Assistant to fill an opening with a multi-specialty practice on multiple work locations (North Manhattan, Bronx, & Queens, NY) Responsibilities of the Physician Assistant: Perform physical exams and patient observations. Record patients' medical histories and symptoms. Create patient care plans and contribute to existing ones. Order, administer, and analyze diagnostic tests. Monitor and operate medical equipment. Diagnose health issues. Administer medicine and other treatments. Detect changes in patients' health and modify treatment plans, as needed. Consult with healthcare professionals and families. Train patients and their families to manage and prevent illness and injury. Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices. If you would like to learn more about other opportunities we offer, please call our office: (800) 608-4025 or submit your Resume/CV to us. Requirements Must have an active NY State License Must be Board Certified Must have at least 1 year experience in Primary Care Preferably Bilingual in Spanish, Russian, or other languages but not a requirement Must be open to travel to North Manhattan, the Bronx and Queens (Patients are clustered geographically for each day, so it is always one area at a time) Benefits The salary for this position is $154,000 - $187,000 / yr (prorated based on the number of days worked) This is a Part-time (2-3 days a week, weekdays) with a potential for full-time Malpractice coverage Productivity bonuses Driver will be provided, who will pick up the provider if reasonably close to the house call route. Potential benefits for full-time employees: Health insurance 3 weeks of vacation 1 week of sick leave CME allowance of $1,000 401K plan
$154,000-187,000
Golden Gate Regional Center
Bilingual Social Worker - Cantonese Required
San Mateo, CA, USA
Social Workers-San Mateo County Starting Salary Bachelor's Degree: $59,826 - $71,791 Master's Degree: $65,929 - $79,114 Are you looking to make an impact and do work you are passionate about? GGRC is committed to assisting people with intellectual and developmental disabilities lead lives of liberty and opportunity. We are currently hiring Social Workers in our San Mateo Office. When you are considering a new job, it’s normal to have tons of questions. Here are a few things we get asked all the time: Where will I work? This role offers a hybrid schedule giving you the opportunity to work in with clients in their homes in San Mateo County, from our San Mateo office and from the comfort of your own home. What you’ll Do: Under the direction of the designated Supervising Social Worker, this position using Person Centered practices assesses the needs of developmentally disabled individuals and their families and develops and implements the person’s Individual Program Plan and coordinates associated services. This position has the responsibility for managing a wide range of active cases requiring the skills of a professionally trained social worker, including creative planning in seeking and acquiring services for individuals supported. This position meets with the individuals at their residence or in the community to design and develop the Individual Program Plan for the person supported, then implements, monitors and revises the program plan, assess needs and identifies barriers to individual’s developmental objectives. Initiates and terminates regional center funding and insures that purchased services are provided. Prepares required reports and documentation in a timely and accurate manner. Maintains records in compliance with federal and state requirements. Acts as an advocate with individual supported and their family to assure receipt of entitled services and to assure client's rights are achieved. Encourages individuals supported and their families to fully participate in coordinating and utilizing the resources available and reviews and ensures that the individuals supported receive appropriate and effective services from existing community resources. Initiates referrals and monitors progress of vendored services, evaluating availability and effectiveness of services. Identifies community service needs or gaps and assists community resources in the development of needed services and improving the quality of services. May provide intake services and outreach services as assigned. Participates in internal and community committees and task forces as assigned. Requirements You have: Knowledge of principles, objective and techniques of counseling individuals; Knowledge of normal and abnormal individual and group behavior, human growth and development of family relationships; Knowledge of community structure and organization and how to intervene constructively on behalf of individuals supported; Knowledge in the areas of: identifying and navigating generic services, objective and techniques of counseling individuals and typical and atypical child development behavior; Ability to interview skillfully; Ability to develop skills allowing for independent work, exercise judgment in making decisions as well as to cooperate and work as part of an interdisciplinary team; Ability to stimulate the cooperation of individuals supported, their families, and stimulate the cooperation of community agencies or individuals; Ability to speak and write effectively; Ability to maintain case records in a clear and concise manner; Ability to establish and maintain effective working relationships with others. Requirements: Bachelor's Degree from an accredited school (social welfare or related human services field preferred but not required); Demonstrated interest in working with persons with developmental special needs; Access to reliable transportation. Benefits Benefits What are the benefits to working with GGRC? Generous Tuition Reimbursement Program that reimburses qualifying employees up to $10,000 per fiscal year. We offer a comprehensive benefits package including Medical and Dental benefits with a generous employer contribution and additional employer paid Life, Disability and Vision coverage 10% employer contribution to a 403(b) retirement account to help you save for the future! GENEROUS TIME OFF BENEFITS!!! No really, we mean generous: 13 vacation days, 15 sick days, 11 paid holidays, 6 personal and up to 5 paid days for continuing education What makes GGRC so special? GGRC values diversity, we believe in creating an environment where people of all backgrounds can collaborate to find solutions to complex problems. We are community minded and passionate. GGRC values each person as a full, robust, and unique individual and interacts with each person in a manner that is respectful and responsive. We endeavor to place each person at the center of his, her or their own life. We approach each person as an expert on his, her or their own life and identity with a clear and attentive inquiry into what is important to, as well as important for, that one person (whether coworker or person-served, family member or other stakeholder). How to apply: GGRC values diversity; people of all backgrounds are encouraged to apply. Please complete the application and submit your most recent resume. If you feel that the questions do not accurately capture what you have to offer Golden Gate Regional Center, you are also welcome to attach a cover letter. Applications are being reviewed on a rolling basis so we encourage you to submit yours soon. We look forward to reading your application. Golden Gate Regional Center is an Equal Opportunity Employer.
$59,826-79,114
Cookie
Cookie Settings
© 2025 Servanan International Pte. Ltd.