- CVS Health (St. Louis Park, MN)
- …Support community development, member education, and other activities as requested by the Director of Medicare Operations and as customer service demands ... we do it all with heart, each and every day. **Position Summary** As a Medicare Member Advocate supporting the Allina Health | Aetna plan, you will engage with… more
- Elevance Health (Walnut Creek, CA)
- **Medical Director - Medicare and Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... onboarding and skill development. Candidates must live in California. The **Medical Director ** will be responsible for utilization review case management for … more
- Centene Corporation (Jefferson City, MO)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Commonwealth Care Alliance (Boston, MA)
- …Year Term **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Aston Carter (Honolulu, HI)
- …the organization and takes appropriate action to incorporate changes into day-to-day operations . Responsible for apprising Senior Director of Plan Operations ... Description The Senior Enrollment Manager is responsible for the operations of the companies Enrollment Department which includes enrollment/disenrollment… more
- Commonwealth Care Alliance (Boston, MA)
- …of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for ... 011250 CCA-Claims Job Description **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a… more
- SUNY Upstate Medical University (Syracuse, NY)
- …the supervision of a licensed provider. The RN/CNS will report to the UUMAS Director of Quality and Practice Operations and collaborate closely with Primary Care ... Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care clinics. This role… more
- CVS Health (Nashville, TN)
- …We are looking for a Principal Data Scientist to join our Aetna Medicare (STARS Portfolio) team at CVS Health. This high-level individual contributor will partner ... closely with the Executive Director of Aetna STARS Analytics to drive hands on...Bachelor's degree in Mathematics, Statistics, Computer Science, Economics, Physics, Operations Research, Engineering, or related discipline + Master's degree… more
- Northwell Health (Westbury, NY)
- …viability of Northwell Health by effectively managing the organization's revenue capture operations . The Director works in close partnership with many aspects ... a comprehensive and seamless revenue cycle throughout Northwell Health. In addition, the director plays a key role as a subject matter expert in hospital coding… more
- Sutter Health (Palo Alto, CA)
- …**Organization:** PAMF-Palo Alto Medical Foundation PAD **Position Overview:** The Senior Director plays an essential role in Sutter Health's ability to successfully ... achieve its ambitious donor engagement and fundraising goals. The Senior Director brings expertise in developing and executing effective, multichannel philanthropy… more
- CVS Health (Springfield, IL)
- …and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy & Operations ) you will be responsible for providing ... pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Director , Growth Operations is responsible for leading the strategic execution of sales ... making and leadership, aligning business objectives with growth strategies. The Director will lead a team of professionals to achieve organizational outcomes.… more
- ChenMed (Metairie, LA)
- …rapidly expanding and we need great people to join our team. The Center Operations Director directs and administers the day-to-day operations of multiple ... service and clinical metrics, goals and objectives meet and/or exceed expectations. The Director , Center is an individual that, first and foremost, has a strong… more
- CenterWell (Mesa, AZ)
- …a part of our caring community and help us put health first** The Associate Operations Director (AOD) leads Senior Focused Primary Care clinical operations ... RESPONSIBILITIES *Leadership & Operational/Organizational Management: *Proven experience in clinical operations and financial management, including P&L responsibilities. *Proficiency in… more
- AccentCare, Inc. (Odessa, TX)
- Overview Find Your Passion and Purpose as a Territory Operations Director - Home Health RN Registered Nurse Reimagine Your Career in Corporate Healthcare As a ... first AccentCare-branded scrubs for patient-facing employees Qualifications Be the Best Territory Operations Director - Home Health RN Registered Nurse You Can Be… more
- Akumin (Palm Beach Gardens, FL)
- Role is based in Florida. The **Senior** ** Director of Operations ** manages the daily operations , and planning the use of materials and human resources. ... etc.) + Reviews staffing model and recommends optional solutions to VP of Operations + Coordinates and communicates across remote sites and shares best practices… more
- Centene Corporation (Dover, DE)
- … and Care Coordination Director to manage and optimize LTSS and Medicare -Medicaid Duals program operations , focusing on improving quality metrics and member ... initiatives for both the Long-Term Services and Supports (LTSS) and Medicare -Medicaid Duals populations. Additionally, the Medical Director will collaborate… more
- State of Colorado (Denver, CO)
- …Only: Experience Only: Ten (10) years of relevant experience in overseeing Medicaid or Medicare fraud, waste, and abuse (FWA) operations that includes work on: + ... Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4941547) Apply Fraud Waste and Abuse Division … more
- Lumeris (New York, NY)
- …its people and empowers you to make an impact. **Position:** Senior Director , Partner Operations **Position Summary:** Provides executive leadership and ... targeted outcomes for health system and provider accounts. Oversees operations for health system customers. **Job Description:** **Primary Responsibilities** +… more
- Beth Israel Lahey Health (Burlington, MA)
- …business operations . **Fiscal** 1. In conjunction with the Executive Director , develops, implements and monitors annual operating budgets and select research ... United Network for Organ Sharing (UNOS) and Center for Medicare and Medicaid Services (CMS). Implements operational policies processes...Manager and Nurse Manager Works as a team in operations 4. Service Line Director Direct report… more
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