Jeremy Moser

Experience

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  Cigna

  Jan 1995 - Apr 1998

  Contracts Manager

  • Negotiated and implemented HMO, PPO and Medicare contracts with medical groups, hospitals and ancillary providers. • Analyzed and administered multi-million dollar shared-risk budgets and incentive programs for capitated medical groups. • Performed strategic planning and cost analysis related to existing and potential contracts. • Participated in planning and analysis related to CIGNA’s medical cost reduction initiatives. • Managed organ transplant contracting efforts for Northern California region. • Developed policies and procedures to ensure compliance with NCQA standards. • Created and managed credentialing process to assess healthcare facilities.• Hired, trained and supervised staff. Show less

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  Brown & Toland Medical Group

  Jan 1998 - Jan 2002

  • Created Compliance Department at Brown & Toland.• Monitored legislative and regulatory activities and participated in state-level lobbying efforts, including the development of position papers and meetings with legislators/regulators.• Managed relationships with trade associations, legislators and regulatory agencies, including the Centers for Medicare and Medicaid Services (CMS) and the California Department of Managed Health Care (DMHC).• Oversaw activities related to maintaining Brown & Toland’s license with the DMHC.• Conducted training and implementation workshops to ensure company-wide compliance with federal and state laws and regulations.• Managed HIPAA assessment and implementation efforts company-wide.• Represented Brown & Toland on multiple ICE teams and was directly responsible for standardizing the implementation of multiple legislative and regulatory requirements in the California health care industry.• Participated on the California Association of Physician Group’s Legislative Steering Committee.• Developed and managed Compliance Department budget. • Negotiated all vendor contracts. Show less

  • Compliance Manager

    Jan 1999 - Jan 2002

  • Senior Contracts Specialist

    Jan 1998 - Jan 1999
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  Self Employed

  Jan 2002 - Jun 2014

  Healthcare Compliance Consultant

  • Manage company-wide compliance program.• Create and execute complex project plans to ensure compliance with federal and state laws and regulations, including HIPAA, ARRA and HITECH.• Coordinate comments/feedback on proposed legislation and regulations to federal, state and local legislators and regulators.• Act as in-house subject matter expert on health care laws and regulations.• Work with management to ensure that Brown & Toland’s contracts with health plans, physicians and vendors comply with federal and state laws and regulations.• Develop and maintain corporate and department-level compliance policies and procedures. Consult with other departments to draft and implement policies and procedures that relate to compliance.• Participate in implementation of Accountable Care Organization (ACO) product.• Negotiate HIPAA Business Associate Agreements and ACO agreements with subcontractors.• Develop and conduct company-wide fraud, waste and abuse training.• Manage activities of Privacy Office including investigation and resolution of all HIPAA privacy and security issues. • Create and manage content on Compliance Department’s Web site.• Participate in Industry Collaboration Effort (ICE) activities to standardize the implementation of laws and regulations throughout the California health care industry. Show less

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  Brown & Toland Physicians

  Jun 2014 - Mar 2020

  • Manager, Compliance and Government Affairs/Information Security Officer/Privacy Officer

    Mar 2015 - Mar 2020

  • Regulatory and Government Affairs Manager

    Jun 2014 - Mar 2015
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  Providence

  Mar 2020 - now

  • Director, Contracting Compliance

    Jun 2021 - now

  • Payer Contracting Compliance Manager

    Mar 2020 - Jun 2021