- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- State of Michigan (Grand Rapids, MI)
- Physician Manager 20 - Medical Director Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4848644) Apply Physician Manager 20 - Medical ... at MVH, please click here (https://www.youtube.com/watch?v=o92V-nOxaKs) . Serve as Medical Director for Michigan Veteran Homes at...level of experience in following Centers for Medicaid and Medicare Services (CMS) for long-term care. + None +… more
- Molina Healthcare (Grand Rapids, MI)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Molina Healthcare (Grand Rapids, MI)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Bayer (Grand Rapids, MI)
- …minds to make a real difference, there's only one choice.** **Associate Director , Field Reimbursement, Oncology - Great Lakes Region** **Associate Director , ... HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working… more
- Gentiva (Grand Rapids, MI)
- …diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director or Primary Care physician. **As a Nurse Practitioner, ... tests within the scope of professional practice. Order treatments and durable medical equipment as indicated. + Communicate clinical findings to the PSC Physician… more
- Molina Healthcare (Grand Rapids, MI)
- …knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates and analyzes, Complex Provider contracts including ... and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract… more