- buyer (New York, NY)
- …including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, ... building strong relationships with its members and providers.Position OverviewThe Senior Director of IT Core Systems is responsible for evaluating operational… more
- buyer (New York, NY)
- …of patient placement in collaboration with health plan members.Communicates with Medical Director regarding all outpatient/diversionary requests for health care ... of education and trainings.Performs other appropriate BH UM/CM duties as assigned by Medical Director , Director of Children's Special Services, and/or the… more
- Creekview Health and Rehabilitation (Knoxville, TN)
- …Health and Rehabilitation Come join our team and start making a difference! DIRECTOR OF REHABILITATION - FULL TIME - CREEKVIEW - KNOXVILLE, TN Creekview Health ... staff. We are seeking a dynamic therapist as the Director of Rehabilitation to manage our stable in-house team...facility is independently operated with local leadership and no corporate red tape Decisions made at the facility for… more
- RELI GROUP INC (Windsor Mill, MD)
- …up to $100 million projects Leads and supports development and execution of corporate and portfolio growth strategy and provides thought leadership in achieving the ... and monitoring/auditing strategy for the model participants As the program director , oversees coordination of personnel and resources required to successfully… more
- Home Care Evolution (Vienna, VA)
- …progress and promptly report clinical changes to the RN Case Manager or Director of Nursing. Support and participate in Quality Assurance (QA) activities, including ... staff to resolve them in a timely manner. Ensure adherence to Medicare , Medicaid, and agency-specific policies and procedures. Maintain accurate, timely records… more
- Humana (Topeka, KS)
- **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 (Olympia, WA)
- **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 (Lansing, MI)
- …first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes ... diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors… more
- RWJBarnabas Health (Oceanport, NJ)
- …filings. In partnership with the Vice President of Corporate Reimbursement , the Director will manage the completion of DSH, Medicare Bad Debts, Wage Index, ... Director , Corporate Reimbursement (Hybrid/Remote)Req #:0000180233 Category:Accounting/Finance...as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... Description: Summary: Conducts case management program activities in accordance with departmental, corporate , NYS Department of Health (DOH), Centers for Medicaid & … more
- Henry Ford Health System (Detroit, MI)
- …of the nation's premier academic and integrated health systems, is seeking a Director of Corporate Reimbursement to lead critical financial functions that ... thoughtful integration of reimbursement practices into systemwide financial strategies. The Director will serve as a trusted partner to executive leadership,… more
- Humana (Montgomery, AL)
- …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 (San Juan, PR)
- …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 (Raleigh, NC)
- …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
- AdventHealth (Altamonte Springs, FL)
- …impacts of proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for ... and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital… more
- AdventHealth (Orlando, FL)
- …Certified Fraud Examiner + Certified Financial Services Auditor **Job Summary:** The Director is responsible for completion of corporate compliance, corporate ... In addition to performing audits and investigations for AdventHealth, the Director will conduct/supervise/assist in compliance, corporate responsibility and… more
- Abbott (Washington, DC)
- …Washington, DC location in the Government Affairs function. As the Government Affairs Director for Corporate Reimbursement, you will develop, lead and execute ... spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues… more
- Integrative Emergency Services (Lawton, OK)
- …+ Eligible to participate in Medicare and Medicaid + Prior experience as a Medical Director or Assistant Medical Director Preferred: + MBA or ... Site Medical Director - Emergency Department Southwestern...are attained. Will interface with key members of IES Corporate , Clinical, Operational, and Hospital leadership regarding the development… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Governmental Reporting is responsible for ensuring that Houston Methodist meets all internal and external financial and ... governmental reporting requirements. Requirements include Medicare cost reports, Federal Tax Returns Health and Human Services (HHS)/Centers for Medicare and… more
- Centene Corporation (New York, NY)
- …regulatory, state, corporate , and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician committees including ... providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and families...+ Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the… more
