- Stanford Health Care (Palo Alto, CA)
- …America) **This is a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's Office, ... Department of Health Care Access and Information (HCAI) In addition, the Director of Reimbursement oversees the organization's responses to government audits and… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider ... network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance operational engagement, member access, provider… more
- Somatus (Mclean, VA)
- …the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional ... mental well-being + Community engagement opportunities + And more! **The Senior Director of Value-Based Care** (VBC) is a strategic and influential leader… more
- Organon & Co. (Plymouth Meeting, PA)
- **Job Description** **The Position** The Director of State Government Affairs will provide direction, coordination and execution of State Policy and Government ... to work collaboratively with commercial colleagues. + Experience working with state Medicaid programs and benefits. + Strong understanding of state coverage and… more
- HealthCare Support (Houston, TX)
- …approved medical guidelines. Refers cases that do not meet criteria to Medical Director for review. 2. Assists in discharge planning especially Home Health ... fill an opening with a Prestigious HealthCare Company in Remote Houston TX . Daily Responsibilities for Utilization Review...services and if not meeting criteria, refer to the Medical Director . 3. Participates in Community Nursing… more
- Stanford Health Care (Palo Alto, CA)
- …federal and state regulations and guidelines, CMS (Centers for Medicare and Medicaid Services) and OIG (Office of Inspector General) compliance standards. Applies ... and other reviews as directed by the Manager and Director of HIMS Coding and Compliance Department. + Evaluates...Knowledge of health information systems for computer application to medical records + Knowledge of ICD-10-CM & CPT-4 coding… more
- Commonwealth Care Alliance (Boston, MA)
- …performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation Partnerships and Provider Engagement. The Provider Engagement team ... overall member experience. **Working Conditions:** + This is a remote or hyrbrid role with the expectation of working...Experience (must have):** + 5+ years + Experience with Medicaid and Medicare products and programs + Experience or… more
- Humana (Indianapolis, IN)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- Humana (Topeka, KS)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies...cost. + Design and perform actuarial studies related to medical care costs and trends. + Research and develop… more
- Humana (Washington, DC)
- …caring community and help us put health first** The Associate Director , Procurement generates and implements efficient sourcing and category management strategies. ... the company's supply portfolio ensuring transparency of spending. The Associate Director , Procurement requires a solid understanding of how organization capabilities… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other...7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- NTT DATA North America (Albany, NY)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Senior Medicaid Solution Architect to join our team in Albany, New York (US-NY), ... Operations & Systems The Senior Solution Architect will report to the Technology Director for the Division of Operations and Systems and have responsibility for… more
- Centene Corporation (Salem, OR)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Evolent (Oklahoma City, OK)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …territory account managers and HEOR/ medical + Responsible for supporting the Sr. Director , Federal National Accounts & Medicaid in speed to access and gross ... Director Federal Account Management VA DoD - Remote Date: Oct 23, 2025 Location: Parsippany, United States,... of Federal Account Management reports to the Senior Director Federal National Accounts and Medicaid and… more
- Danaher Corporation (Memphis, TN)
- …the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for ... coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will play a pivotal… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (San Juan, PR)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
Related Job Searches:
Director,
Director Medicaid Remote,
Medicaid,
Medical,
Medical Director,
Medical Director Medicaid,
Remote