- Molina Healthcare (Louisville, KY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (Louisville, KY)
- …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
- Molina Healthcare (Louisville, KY)
- **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
- Humana (Louisville, KY)
- …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 ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Molina Healthcare (Louisville, KY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (Louisville, KY)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Molina Healthcare (Louisville, KY)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- Humana (Louisville, KY)
- …part of our caring community and help us put health first** The Director , Internal Audit develops, plans and evaluates internal audit programs for the organization's ... ensure compliance with the organization's policies, procedures and standards. The Director , Internal Audit requires an in-depth understanding of how organization… more
- Humana (Louisville, KY)
- …part of our caring community and help us put health first** The Associate Director of the Requisition to Purchase Order (RPO) and Catalog Optimization team provides ... accuracy, relevance, and optimization of procurement catalogs. The Associate Director partners closely with cross-functional teams, enhancing stakeholder experiences… more
- Humana (Louisville, KY)
- …part of our caring community and help us put health first** The Associate Director , IT Talent Management serves as the strategic leader who will deliver programs to ... development and delivery of executive-ready communications and presentations. The Associate Director , IT Talent Management must be a strategic leader and will… more
- Humana (Louisville, KY)
- …part of our caring community and help us put health first** The Associate Director will report directly into the Associate Vice President of Procure to Pay ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Humana (Louisville, KY)
- …a strategic, data-driven leader to guide that transformation. As Associate Director , Marketing Lifecycle Analytics, you'll lead the development of marketing plans ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Molina Healthcare (Louisville, KY)
- …and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and ... recontracting initiatives. Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads preparation… more
- Signature Healthcare (Louisville, KY)
- …development on data points, ie referral conversion rate, referral growth rate, Medicare market share. Establish appropriate processes and goals to achieve the ... and Signature Perks include the following and more! + Medical , Dental and Vision - Voluntary Life/Disability + Free...and Vision - Voluntary Life/Disability + Free Telemedicine with Medical Plan + 401(K) and Roth 401(K) + Tuition… more
- CenterWell (Clarksville, IN)
- … medical expertise with the care team through daily huddles. + Helps Regional Medical Director and Clinic Manager in setting a tone of cooperation in practice ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- Humana (Louisville, KY)
- …senior leadership and improve customer experiences. + . Reporting directly to the Director , the Senior Professional will work in close partnership with the NPSr ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- BrightSpring Health Services (Louisville, KY)
- …preferred) and be familiar with online claims processing and Medicaid and Medicare billing practices. We offer: DailyPay Flexible schedules Competitive pay Health, ... processes and system requirements and seeks resolution from originator, supervisor or director + Performs outbound courtesy calls as designated by the business… more
- Waystar (Louisville, KY)
- …and innovative payer strategies. This role will report to the Sr Director of Product Operations. **WHAT YOU'LL DO** **Payer Relationship Management:** + Identify ... systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... Local Standards, guidelines and regulations and as required by Director of Nursing. + Confirm that all nursing personnel...and Signature Perks include the following and more! + Medical , Dental and Vision - Voluntary Life/Disability + 401(K)… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... Local Standards, guidelines and regulations and as required by Director of Nursing. + Confirm that all nursing personnel...and Signature Perks include the following and more! + Medical , Dental and Vision - Voluntary Life/Disability + 401(K)… more