- Humana (Santa Fe, NM)
- **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 (Santa Fe, NM)
- **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
- Molina Healthcare (Santa Fe, NM)
- **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 or programs. Duties include… more
- Humana (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Humana (Santa Fe, NM)
- …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
- Molina Healthcare (Santa Fe, NM)
- …the state health plan. Works with direct management, senior leadership/management, Corporate , and staff to develop and implement standardized provider contracts and ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Humana (Santa Fe, NM)
- …caring community and help us put health first** **Clinical Business Lead, Humana Medicare Advantage** As Regional Clinical Business Lead, you serve as a key member ... clinical strategy, performance monitoring, and continuous quality improvement within the Medicare Advantage program to support improving the health of members. The… more