- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health ... claims and preservice appeals. The Corporate Medical Director works on...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Providence, RI)
- **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 and preservice appeals. The Corporate Medical Director works on...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Providence, RI)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Providence, RI)
- …the Medicare Line of Business. **Additional Information** Typically reports to Lead or Corporate Medical Director , depending on size of region or line of ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Providence, RI)
- …adapt and the courage to innovate **Additional Information** Typically reports to a Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Point32Health (Canton, MA)
- …service lines for Medicare , Medicaid and Commercial product lines. The Director also identifies opportunities to reduce medical and administrative costs by ... we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Director , Ancillary Contracting leads the development and management of… more
- Humana (Providence, RI)
- …caring community and help us put health first** The Associate Director ; Software Renewals establishes and implements hardware and software acquisition, protection, ... procedures that are aligned with IT standards and strategy. The Associate Director ; Software Renewals requires a solid understanding of how organization capabilities… more
- Fallon Health (Worcester, MA)
- …adjustment lines of business. + Comprehensive program integration to align with corporate initiatives to drive quality improvement and medical trend management. ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
- Humana (Providence, RI)
- …clinical strategy, performance monitoring, and continuous quality improvement within the Medicare Advantage program to support improving the health of members. The ... the Regional Vice President of Health Services (RVP) and Health Services Director (HSD) . This position focuses on enabling connections with providers, supporting… more
- Aveanna Healthcare (Worcester, MA)
- …establishes and participates in program development and implementation. The Area Clinical Director team members report up through the Area Vice President who ... Communicates formally and informally (in person or phone) with Corporate Representatives ( corporate level) and Area Clinical...time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Fallon Health (Worcester, MA)
- …and provides direction and support. + Works with Department Supervisors, Manager and/or Director , or Clinical Staff including the Medical Directors to resolve ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... regarding the grievance/appeal. * Print, mail, and triage letters at the FH corporate office located at 10 Chestnut Street, Worcester, MA. * Identifying the need… more