- Molina Healthcare (Milwaukee, WI)
- …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 (Milwaukee, WI)
- …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 (Milwaukee, WI)
- **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 (Milwaukee, WI)
- …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 (Milwaukee, WI)
- …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 (Milwaukee, WI)
- …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
- Molina Healthcare (Milwaukee, WI)
- …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
- Grifols Shared Services North America, Inc (Milwaukee, WI)
- …and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing ... access customer segment . Support reimbursement, coding, and coverage-related responsibilities for Medicare Part B, Centers for Medicare and Medicaid (CMS)… more
- Gentiva (Milwaukee, WI)
- …We have an exciting and rewarding opportunity for a Home Health RN Executive Director / RN Administrator to join our leadership team. This role is ideal for ... compliance with all applicable federal, state, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Oversee the coordination of patient admissions… more
- Genesis Healthcare (Oconomowoc, WI)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of...in the state of practice 3. Thorough knowledge of Medicare and third party billing required 4. Must have… more
- Molina Healthcare (Milwaukee, WI)
- …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
- Gentiva (Milwaukee, WI)
- …medical needs. You will work autonomously in collaboration with the Palliative Medical Director , delivering exceptional care and guiding patients and families ... every stage of treatment. **Responsibilities:** + Collaborate with the Palliative Medical Director and care team to deliver comprehensive, patient-centered… more
- Gentiva (Milwaukee, WI)
- …Care Manager to join our hospice team. Reporting directly to the Executive Director or Administrator, you will oversee patient care activities to ensure the delivery ... based on clinical judgment and priority + T riage incoming phone referrals and medical concerns in a timely, compassionate, and professional manner + L ead or… more
- Gentiva (Milwaukee, WI)
- …Patient Services Coordinator:** + Report directly to the Administrator or Executive Director and oversee the day-to-day coordination of care services. + Schedule and ... of home health disciplines and visit coordination. + Familiarity with Medicare /Medicaid, managed care guidelines, and accreditation standards (ACHC, CHAP, or Joint… more