- 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, ... and regulatory reports to government agencies, including but not limited to: - Medicare and Medi-Cal cost reports -Financial disclosures to the Department of Health… more
- USAA (Tampa, FL)
- …makes us special and impactful. The Opportunity USAA is seeking a talented Director , Retirement Income to lead multiple teams of Health, Life or Retirement Income ... with Legal, Risk and Compliance on interpretation of CMS (Center for Medicare and Medicaid Services) rules to provide guidance and clarification to executive… more
- Commonwealth Care Alliance (Boston, MA)
- …in provider relations, contracting, or network operations, including 3-5 years in a director or senior management role. - Experience with value-based payment ... 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider… more
- Stanford Health Care (Palo Alto, CA)
- …**This is a Stanford Health Care job.** **A Brief Overview** Reporting to the Senior Vice President (SVP) - Chief Compliance and Privacy Officer in the Office of ... Compliance and Privacy, the Executive Director - Compliance and Privacy is responsible for implementing...advise the Chief Compliance and Privacy Officer and other senior leaders. + Identifies, assesses, and mitigates risks related… more
- CSL Behring (King Of Prussia, PA)
- …required data collection and submit all reports needed for compliance. 4. Work with Senior Director , Policy Advocacy & Government Affairs, & Legal to interpret ... **Experience** + Strong knowledge of the regulatory requirements for MDRP, Medicare /IRA, Veteran's Healthcare Act, and other Federal regulations mandating price… more
- CSL Behring (King Of Prussia, PA)
- **The Opportunity** As a member of the US Commercial Finance Team, the Director Finance Business Partner serves as a trusted financial advisor to senior leaders ... performance, pricing, and contracting across payer segments (including Medicaid, Medicare , and Commercial). + Collaborate with (Contracting, Market Access,… more
- Commonwealth Care Alliance (Boston, MA)
- …and quality improvement. - Minimum five (5) years of clinical experience in medical or behavioral health care delivery Required Knowledge, Skills & Abilities: - ... Medicare and Medicaid managed care experience - Demonstrated knowledge...detail - Demonstrated ability to interface and present to senior management effectively - Competent in working with vulnerable… more
- Eisai, Inc (New York, NY)
- At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... to meet objectives for assigned regional payer accounts including Commercial, Medicare and Medicaid (State Medicaid agencies, managed Medicaid, and select client… more
- CHINESE AMERICAN PLANNING COUNCIL (New York, NY)
- …education, school-age care, youth services, workforce development, community services, and senior services. CPC strives to be the premier social service and ... community for many years. JOB SUMMARY Reporting to the Program Director , the full-time Entitlement Benefits Specialist provides comprehensive prescreening and… more
- Commonwealth Care Alliance (Boston, MA)
- …and provider-specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation Partnerships and Provider Engagement. The ... Supports (LTSS) provider organizations that serve One Care and Senior Care Options (SCO) members across Massachusetts. This role...have):** + 5+ years + Experience with Medicaid and Medicare products and programs + Experience or knowledge of… more
- Kanabec County (Mora, MN)
- …by the CHS Administrator/ Director of Public Health and/or the staff. Prices medical supplies for medical supply closet. Assist with flu, senior clinics, ... Keyboard/Clerical: Performs typing/data entry as directed by the CHS Administrator/ Director of Public Health, Home Health Coordinator, Nursing Supervisor(s),… 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
- Molina Healthcare (Davenport, IA)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. **Position Summary** The Executive Director , Strategic Finance will lead a newly established Strategic Finance function within ... Medicare , working alongside MAPD Finance, Part D & Med...science and broader healthcare strategy and operations, the Executive Director will partner closely with Market Finance, Network/Clinical, Actuarial,… more
- CVS Health (Hartford, CT)
- …to drive real change and improve the health of millions are endless. As Lead Director , Enterprise Strategy, you play a pivotal role helping to shape strategy for one ... future of our company. You will work hand-in-hand with senior business leaders to identify and analyze exciting new...discussions + 3+ years of experience in healthcare payor, Medicare , Medicaid or provider consulting experience + 3+ years'… more
- Humana (Lansing, MI)
- …first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes ... diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors… 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 ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… 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 ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight ... for all of Sharp Health Plan products, (Commercial, Exchange, Medicare , POS/PPO) services, and oversees the health care needs...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- Humana (Miami Lakes, FL)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live… more
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