Home 
How Blumble Works 
Search Algorithm 
Your Privacy 
About 
Facebook
Twitter
Blog
fchp
-
EncryptedSite is Encrypted
-
CountryHosted in United States
-
Traffic rank#414,729 Site Rank
-
Site age26 yrs old
-
Site Owner informationWhois info
Website is Safe
Traffic rank
#414,729
#414,729
Site age
26 yrs
26 yrs
Location
United States
United States
Newest job postings for fchp
via LinkedIn
posted_at: 2 days agoschedule_type: Contractor
Overview
About Fallon Health ...
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon
Overview
About Fallon Health ...
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org .
Brief Summary Of Positions
The Medicare Compliance & Regulatory Affairs Associate acts as a regulatory resource to clarify, monitor, and research regulatory requirements, provides proactive compliance monitoring and assessments with regards to key initiatives and increasing compliance requirements, collaborates with business areas and vendors to manage corrective action processes when needed, and supports CMS audits. This includes changes that impact the structure and operation of Medicare Advantage, PACE and other Medicare products as well as Medicare initial and expansion applications, RFIs, RFAs, and compliance versight. Develops legal arguments for Medicare Programs as needed. A component of the position is dedicated to compliance management of Medicare required reporting in accordance to the state and federal requirements. Additionally, this position includes Fallon Policy and Procedure Librarian responsibilities that include sending annual review policy and procedure reminders to business areas, providing education on the development of and uploading of final policies and procedures.
Responsibilities
• Conduct research regarding regulatory and benefit questions to support business requirements including product development, procedural issues and changes for Medicare Advantage, PACE and other Medicare products.
• Assist operational areas, as needed, with the development, updates and/or revisions relevant policies and procedures based on updates to interpretation or regulatory changes from state or federal regulators.
• May include research and analyses of matters related to existing and new regulatory requirements as well as assisting with Medicaid regulations as needed.
• Assume a major role in CMS and State leading work groups and developing work plans that focus on readiness and compliance with CMS and State regulations, manuals and review guides including such areas as:
• Fraud, waste and abuse oversight requirements.
• Reviewing and retaining company contracts and other documents pertinent to the Medicare product(s)
• Coordinating with business areas to gather information needed for regulatory reviews, validations and audits.
• Manages and submits the required Medicare (i.e. Part C & D) reporting as delegated by management. This includes working with multiple Fallon departments and vendors to ensure the submission of data to CMS is in compliance with reporting requirements, and assists with the yearly Part C & D Data Validation.
• Responsible for the oversight of required Medicare Advantage and PACE encounter data reporting requirements and timeline in collaboration with other Fallon departments.
• Manage the oversight and distribution of legislation as it impacts Medicare Advantage, PACE and other Medicare products.
• Provide support to Medicare Advantage, PACE and other Medicare products application submission process and other submissions as needed.
• Develop and and prepare arguments and explanations in response to proposed regulatory changes and inquiries for internal meetings as submission to CMS.
• Seek advice from legal counsel as needed.
• Manage the compliance oversight of Fallon’s First Tier, Downstream and Related Parties (FDRs), including the annual questionnaire distribution, review and, as needed, follow up required with FDRs. May also include acting as the Chair to Fallon’s Government Programs Vendor Oversight Committee which includes owning the content of the Compliance Program Guide for FDRs and Business Partners and Health Care Providers Code of Conduct documents and the Vendor Compliance section of the Fallon Health website.
• Develop, update and/or revise relevant policies and procedures within Medicare Programs based on updates to interpretation or regulatory changes from state or federal regulators.
• Act as a Librarian for certain business areas throughout the organization. This includes sending reminders of the annual reviews as well as providing education on what policies and procedures are and what they are to contain, and uploading of final policies and procedures.
• Engages in various organizational committees and/or work groups to monitor or prepare for CMS audits, coordinates corrective action plan as well as disseminate federal program compliance information as necessary.
• Provide support during audits, to Medicare Advantage and PACE product(s) application submission process and other submissions, and other Medicare Programs special projects and assignments as needed.
Education
Qualifications
Bachelor’s degree required. Advanced degree in law strongly preferred for this position
Experience
5 years managed care or relevant industry experience
#AP23 Show more details...
About Fallon Health ...
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org .
Brief Summary Of Positions
The Medicare Compliance & Regulatory Affairs Associate acts as a regulatory resource to clarify, monitor, and research regulatory requirements, provides proactive compliance monitoring and assessments with regards to key initiatives and increasing compliance requirements, collaborates with business areas and vendors to manage corrective action processes when needed, and supports CMS audits. This includes changes that impact the structure and operation of Medicare Advantage, PACE and other Medicare products as well as Medicare initial and expansion applications, RFIs, RFAs, and compliance versight. Develops legal arguments for Medicare Programs as needed. A component of the position is dedicated to compliance management of Medicare required reporting in accordance to the state and federal requirements. Additionally, this position includes Fallon Policy and Procedure Librarian responsibilities that include sending annual review policy and procedure reminders to business areas, providing education on the development of and uploading of final policies and procedures.
Responsibilities
• Conduct research regarding regulatory and benefit questions to support business requirements including product development, procedural issues and changes for Medicare Advantage, PACE and other Medicare products.
• Assist operational areas, as needed, with the development, updates and/or revisions relevant policies and procedures based on updates to interpretation or regulatory changes from state or federal regulators.
• May include research and analyses of matters related to existing and new regulatory requirements as well as assisting with Medicaid regulations as needed.
• Assume a major role in CMS and State leading work groups and developing work plans that focus on readiness and compliance with CMS and State regulations, manuals and review guides including such areas as:
• Fraud, waste and abuse oversight requirements.
• Reviewing and retaining company contracts and other documents pertinent to the Medicare product(s)
• Coordinating with business areas to gather information needed for regulatory reviews, validations and audits.
• Manages and submits the required Medicare (i.e. Part C & D) reporting as delegated by management. This includes working with multiple Fallon departments and vendors to ensure the submission of data to CMS is in compliance with reporting requirements, and assists with the yearly Part C & D Data Validation.
• Responsible for the oversight of required Medicare Advantage and PACE encounter data reporting requirements and timeline in collaboration with other Fallon departments.
• Manage the oversight and distribution of legislation as it impacts Medicare Advantage, PACE and other Medicare products.
• Provide support to Medicare Advantage, PACE and other Medicare products application submission process and other submissions as needed.
• Develop and and prepare arguments and explanations in response to proposed regulatory changes and inquiries for internal meetings as submission to CMS.
• Seek advice from legal counsel as needed.
• Manage the compliance oversight of Fallon’s First Tier, Downstream and Related Parties (FDRs), including the annual questionnaire distribution, review and, as needed, follow up required with FDRs. May also include acting as the Chair to Fallon’s Government Programs Vendor Oversight Committee which includes owning the content of the Compliance Program Guide for FDRs and Business Partners and Health Care Providers Code of Conduct documents and the Vendor Compliance section of the Fallon Health website.
• Develop, update and/or revise relevant policies and procedures within Medicare Programs based on updates to interpretation or regulatory changes from state or federal regulators.
• Act as a Librarian for certain business areas throughout the organization. This includes sending reminders of the annual reviews as well as providing education on what policies and procedures are and what they are to contain, and uploading of final policies and procedures.
• Engages in various organizational committees and/or work groups to monitor or prepare for CMS audits, coordinates corrective action plan as well as disseminate federal program compliance information as necessary.
• Provide support during audits, to Medicare Advantage and PACE product(s) application submission process and other submissions, and other Medicare Programs special projects and assignments as needed.
Education
Qualifications
Bachelor’s degree required. Advanced degree in law strongly preferred for this position
Experience
5 years managed care or relevant industry experience
#AP23 Show more details...
via LinkedIn
posted_at: 3 days agoschedule_type: Full-time
About Fallon Health:
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. Today, guided by our mission of... improving health and inspiring hope, we strive
About Fallon Health:
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. Today, guided by our mission of... improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter, and LinkedIn.
About Summit ElderCare:
Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.
Brief Summary of Purpose:
Functions as a member of the PACE Interdisciplinary Team and provides social work services and support to participants, families, and other caregivers. Provides direction to bachelors level social workers as assigned by Social Work Manager.
Social Worker, LCSW/LICSW, Competitive Salary, Generous Paid Holidays, Great company with a great mission to keep Seniors in their homes!(Springfield MA)
Opportunity to work with a growth-centered team in a positive work environment!
Education:
Masters degree in Social Work
License:
Valid and unrestricted license to practice social work from the Board of Registration of Social Work of the Commonwealth of Massachusetts.
Valid Driver's License and reliable vehicle required.
Certification:
CPR and Alzheimer’s certification or willingness to be certified.
Experience:
At least two years experience in a Social Work capacity, preferably in a community setting, with a minimum of one year experience working with a frail or elderly population.
Fallon Health Vaccination Requirements:
To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022, all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws Show more details...
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. Today, guided by our mission of... improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter, and LinkedIn.
About Summit ElderCare:
Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.
Brief Summary of Purpose:
Functions as a member of the PACE Interdisciplinary Team and provides social work services and support to participants, families, and other caregivers. Provides direction to bachelors level social workers as assigned by Social Work Manager.
Social Worker, LCSW/LICSW, Competitive Salary, Generous Paid Holidays, Great company with a great mission to keep Seniors in their homes!(Springfield MA)
Opportunity to work with a growth-centered team in a positive work environment!
Education:
Masters degree in Social Work
License:
Valid and unrestricted license to practice social work from the Board of Registration of Social Work of the Commonwealth of Massachusetts.
Valid Driver's License and reliable vehicle required.
Certification:
CPR and Alzheimer’s certification or willingness to be certified.
Experience:
At least two years experience in a Social Work capacity, preferably in a community setting, with a minimum of one year experience working with a frail or elderly population.
Fallon Health Vaccination Requirements:
To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022, all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws Show more details...
via LinkedIn
posted_at: 2 days agoschedule_type: Full-time
Overview
Why should I consider a Nursing opportunity in a PACE program at Summit...
• No Nights!
• No Holidays!
• 8-5 standard schedule!
• The only on-call is a low-volume weekend rotation spread across all the other Nurses!
• Collaborative and supportive full team approach to our care model!
• Some wonderful relationships established with the member participants you care for!
About Fallon Health
Founded in 1977, Fallon Health is a
Overview
Why should I consider a Nursing opportunity in a PACE program at Summit...
• No Nights!
• No Holidays!
• 8-5 standard schedule!
• The only on-call is a low-volume weekend rotation spread across all the other Nurses!
• Collaborative and supportive full team approach to our care model!
• Some wonderful relationships established with the member participants you care for!
About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.
About Summit ElderCare
Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.
Position Summary
Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice.
Responsibilities
Primary job responsibilities:
• Primary nurse not only has the responsibility for the participant, but the authority to advocate for the best care for the participant unique to their situation.
• Fostering a relationship with the caregiver and participant.
• Primary Nurse will take on a Leadership Role.
• Effectively communicate with the healthcare team.
• Assigns tasks and duties to the healthcare team; ensure the tasks are completed; responsible for their panel.
• Develops an individualized plan of care.
• Accountability for assessments, communicating needs and coordinating the care team.
• Primary nurse develops the plan of care
• Reviews and implements Provider’s orders .
• Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated.
• Involves participants and significant other(s) based on needs and abilities.
• Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards.
• Provides for cultural and diverse needs of participants when providing care.
• Monitors and evaluates therapeutic interventions.
• Delegates and or accepts participants’ care responsibilities to other members of the health care team, when appropriate.
• Identifies emergency situations and initiates appropriate nursing orders/interventions.
• Meets the needs of participants in a timely manner.
• Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants.
• Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record.
• Participates in training and orientation of new nursing staff as assigned.
• Assists in the delivery of other nursing services as assigned.
• Participates in the nursing “on-call” rotation as assigned.
• Initiates and completes falls, infection, grievance and incident reports
• Participates in CMS calls when deemed necessary.
• Active participant in the site specific committees.
• Participates in the post IDT huddle and any other additional meetings
• Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director.
• Assumes the role of the home care nurse, floor or triage nurse per the direction of the Clinical Nurse Manager or Site Director as appropriate.
• Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures.
• Functions independently to administer medications and treatments as ordered by the provider. Functions independently in the primary nurse role. Independent in performing a nursing assessment and executing the plan of care in all settings the participant maybe in.
• Medication administration
• Performing bladder scans, EKG, Point of Care, and glucometer testing
Qualifications
Education, Licenses, certification and experience requirements:
Education: Graduate of an accredited school of nursing
License: Current license as an RN in the state of Massachusetts
Certification: CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential.
Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population.Ambulatory care or home care experience helpful.
Other: Reliable Transportation Required
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
PM16 Show more details...
Why should I consider a Nursing opportunity in a PACE program at Summit...
• No Nights!
• No Holidays!
• 8-5 standard schedule!
• The only on-call is a low-volume weekend rotation spread across all the other Nurses!
• Collaborative and supportive full team approach to our care model!
• Some wonderful relationships established with the member participants you care for!
About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.
About Summit ElderCare
Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.
Position Summary
Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice.
Responsibilities
Primary job responsibilities:
• Primary nurse not only has the responsibility for the participant, but the authority to advocate for the best care for the participant unique to their situation.
• Fostering a relationship with the caregiver and participant.
• Primary Nurse will take on a Leadership Role.
• Effectively communicate with the healthcare team.
• Assigns tasks and duties to the healthcare team; ensure the tasks are completed; responsible for their panel.
• Develops an individualized plan of care.
• Accountability for assessments, communicating needs and coordinating the care team.
• Primary nurse develops the plan of care
• Reviews and implements Provider’s orders .
• Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated.
• Involves participants and significant other(s) based on needs and abilities.
• Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards.
• Provides for cultural and diverse needs of participants when providing care.
• Monitors and evaluates therapeutic interventions.
• Delegates and or accepts participants’ care responsibilities to other members of the health care team, when appropriate.
• Identifies emergency situations and initiates appropriate nursing orders/interventions.
• Meets the needs of participants in a timely manner.
• Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants.
• Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record.
• Participates in training and orientation of new nursing staff as assigned.
• Assists in the delivery of other nursing services as assigned.
• Participates in the nursing “on-call” rotation as assigned.
• Initiates and completes falls, infection, grievance and incident reports
• Participates in CMS calls when deemed necessary.
• Active participant in the site specific committees.
• Participates in the post IDT huddle and any other additional meetings
• Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director.
• Assumes the role of the home care nurse, floor or triage nurse per the direction of the Clinical Nurse Manager or Site Director as appropriate.
• Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures.
• Functions independently to administer medications and treatments as ordered by the provider. Functions independently in the primary nurse role. Independent in performing a nursing assessment and executing the plan of care in all settings the participant maybe in.
• Medication administration
• Performing bladder scans, EKG, Point of Care, and glucometer testing
Qualifications
Education, Licenses, certification and experience requirements:
Education: Graduate of an accredited school of nursing
License: Current license as an RN in the state of Massachusetts
Certification: CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential.
Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population.Ambulatory care or home care experience helpful.
Other: Reliable Transportation Required
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
PM16 Show more details...
Search trends for fchp
Norton safe Web