- Stanford Health Care (Palo Alto, CA)
- If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting ... a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within...reports to government agencies, including but not limited to: - Medicare and Medi-Cal cost reports -Financial disclosures to the… 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
- Stanford Health Care (Palo Alto, CA)
- If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting ... and Privacy Officer in the Office of Compliance and Privacy, the Executive Director - Compliance and Privacy is responsible for implementing and managing the… more
- Lundbeck (Deerfield, IL)
- Director Compensation Benefits and HR Operations US Requisition ID: 7100 Location: Deerfield, IL, US Do you want to join a team where the mission is meaningful, the ... Transparency, Section 125 regulations, 5500, Health Care Reform, Workers Compensation, Medicare , Social Security, DOL, FLSA) + Clear, precise and effective verbal… more
- Emanate Health (Covina, CA)
- …you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as ... functions. The coding specialist will work with the IPA Director , Health Plan, and MSO personnel on HCC and...ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. Coding specialist… more
- Stanford Health Care (Palo Alto, CA)
- If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting ... EMTALA, the Stark Law, Conflicts of Interest, Gifts and Entertainment, and Medicare and Medicaid program requirements. + Develop written policies, procedures, and… 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 ... have):** + 5+ years + Experience with Medicaid and Medicare products and programs + Experience or knowledge of...self-motivated, with the ability to work independently and as part of a team to meet departmental goals. +… more
- The Joint Commission (Oakbrook Terrace, IL)
- …appropriate judgment to seek assistance from others, including Central Office, the Field Director on call, the program specific Field Director , the Standards ... periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of-compliance reports. + Collaborate in a productive manner with… more
- Humana (Helena, MT)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for ... services. The Medical Director work assignments involve moderately complex...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- CVS Health (Hartford, CT)
- …and more compassionate. And we do it all with heart, each and every day. Executive Director , Medicare Part D Strategy leader will lead the development and ... advancement of the organization's strategy for Medicare Part D, spanning both the ...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Elevance Health (Tampa, FL)
- ** Medical Director - Florida Medicare ...and expectations for time onsite will be discussed as part of the hiring process. The health of our ... must reside in Florida near our Miami or Tampa locations.** The ** Medical Director ** will support the following Florida Medicare plans: Simply Healthcare… more
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. **Position Summary** The Divisional CFO for Medicare Part D and Medicare Supplement is responsible for the financial ... + Serve as the chief financial partner to the Medicare Part D and Medicare ...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CVS Health (Hartford, CT)
- …the US. **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part C appeals (both provider and ... * Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation...in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance &… more
- Humana (Honolulu, HI)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims. The Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- BlueCross BlueShield of North Carolina (NC)
- …Data Interpretations, Finance, Finance Strategy, Financial Modeling, Health Insurance, Leadership, Medicare Advantage, Medicare Part D, Medicare ... **Job Description** Join our team as Director , Actuarial Services - Medicare Pricing...actuaries responsible for pricing, forecasting, and strategic support of Medicare Advantage, Medicare Supplement, and Part… more
- Elevance Health (AR)
- Provider Network Management Director ( Medicare Network Build) JR167138 **Preferred Location** : Commuting distance to the Little Rock, Arkansas office. **Hybrid ... is granted as required by law._ The **Provider Network Management Director ** develops the provider network in **Arkansas** through contract negotiations,… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... with regulatory, state, corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician committees including… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... belief system.** We believe wellness and sickness are both part of a lifelong partnership, and that everyone could...This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities.… more
- Humana (Miami Lakes, FL)
- …must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work ... **Become a part of our caring community and help us...The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,… more
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