- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Jefferson City, MO)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- Humana (Jefferson City, MO)
- …party reporting including notification, collection, analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee ... caring community and help us put health first** The Associate Director , Procurement generates and implements efficient sourcing and category management strategies.… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Humana (Jefferson City, MO)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture** + **Knowledge and experience with national guidelines… more
- Humana (Jefferson City, MO)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture + Knowledge and experience with national guidelines… more
- Humana (Jefferson City, MO)
- …and related tasks; works under minimal supervision; and assists in supporting the medical director team and leaders in meeting enterprise-wide business ... community and help us put health first** The Corporate Medical Director (CMD) relies on medical...+ Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more
- Evolent (Jefferson City, MO)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management ... team . We can offer you a meaningful way to...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Centene Corporation (Jefferson City, MO)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... 28 million members as a clinical professional on our Medical Management/Health Services team . Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Evolent (Jefferson City, MO)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... team . We can offer you a meaningful way to...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Jefferson City, MO)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... will be a key member of the utilization management team . We can offer you a meaningful way to...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Blue KC (MO)
- …+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, ... of our offerings include:** **Highly competitive total rewards package, including comprehensive medical , dental and vision benefits as well as a 401(k) plan that… more
- ChenMed (St. Louis, MO)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... expanding and we need great people to join our team . The Associate Market Clinical Director will...to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model,… more
- Gentiva (St. Louis, MO)
- …Drive Excellence. Transform Palliative Care.** We are seeking an experienced and compassionate Director of Palliative Care - RN to join our team . This ... clinical and financial operations of the Palliative Care Program. The Director ensures high standards of patient care, compliance with regulatory requirements,… more
- Elara Caring (Jefferson City, MO)
- …make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the ... Right Place. **Job Description:** **Branch Director - Personal Care Services (PCS)** **Location:** **Jefferson City,...a culture of safety. + **Building and developing your team ** : Recruit, mentor, and retain top talent; provide… more
- Humana (Jefferson City, MO)
- …of our caring community and help us put health first** The Associate Director , Business Intelligence solves complex business problems and issues using data from ... external sources to provide insight to decision-makers. The Associate Director , Business Intelligence requires a solid understanding of how...applications, and data resources. The role will lead a team of up to approx. 7-9 direct associates. **Key… more
- Gentiva (St. Louis, MO)
- …leadership ensures compassionate care reaches every patient, every day. As an Executive Director Specialist - RN, you'll serve as the operational and clinical leader ... with all federal, state, and organizational standards. **What You'll Do as Executive Director Specialist - RN:** + Serve as the Administrator on record at assigned… more
- Baylor Scott & White Health (Jefferson City, MO)
- …dashboards and reports for senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare/ Medicaid audit ... **Job Summary** The Director , Denial Resource Center is responsible for the..., Denial Resource Center will lead a highly skilled team of Registered Nurses, Certified Coding Specialists, Complex Appeal… more
- Humana (Jefferson City, MO)
- …part of our caring community and help us put health first** The Associate Director of DevOps Engineering is a strategic and technical leadership role responsible for ... guiding our DevOps initiatives. You will lead a team of talented DevOps engineers, focusing on standardization, building partnerships with software delivery teams to… more
- Gentiva (St. Louis, MO)
- …diagnosis, treatment, consultation, and follow up under the direction of the Palliative Medical Director (if required under State law). + Establish, implement, ... **Overview** We're looking for a ** Director of Palliative Care - Nurse Practitioner** to join our team . You will report directly to the VP of Palliative Care.… more