- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Job Summary:** The System Executive Director - Managed Care position is responsible for planning, ... and procedures, processes, and measurement tools. The System Executive Director - Managed Care is...building initiatives and business opportunity assessment with administrative and clinical leadership. Ensures managed care … more
- City and County of San Francisco (San Francisco, CA)
- …(CalAIM) and their impacts on clinical care + Collaborates with the Director of Managed Care and with OCC, Utilization Management (UM), and Quality ... psychiatric services. The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides...after 10/1/2023 The role will be 10-30% dedicated to clinical responsibilities with the remaining 70-90% dedicated to Deputy… more
- Omnicell, Inc. (Grapevine, TX)
- …Capacity. 1. Since 1992, Omnicell has been committed to **transforming pharmacy care ** through **outcomes-centric innovation** designed to optimize clinical and ... Client Solutions, Information Technology, Accounting, and Finance Teams to ensure all managed pharmacies are performing at the highest level. Essential functions +… more
- Rady Children's Hospital San Diego (Murrieta, CA)
- …funded position with an end date of 06/30/26** JOB SUMMARY: The Enhanced Care Management (ECM) Supervisor manages the daily operations of the satellite ECM Program ... to the main ECM Program staff. Participates in interdisciplinary case conferencing care planning. Facilitates and ensures that all ECM members receive all ECM… more
- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must have ... requirements + The unique complex needs of the foster care population + Medicaid Managed Care...the MMCP's service area or provider network Interact with clinical and billing staff Refer children for needed services… more
- University of Washington (Seattle, WA)
- …pursuits and natural beauty. **UW Medicine has an outstanding opportunity for a Director of Clinical Regulatory Affairs and Associate General Counsel to join ... their team.** **GENERAL DESCRIPTION AND PURPOSE** The Director of Clinical Regulatory Affairs ( Director...Officer. UW Medicine's programs include the provision of medical care to underserved and disadvantaged persons and maintaining the… more
- Diversicare Healthcare Services & Diversicare Ther (Tupelo, MS)
- …Additionally provide subject matter consultation on Medicare, Medicaid and Managed Care reimbursement and regulatory guidelines. **Responsibilities** The ... expectations."_ Diversicare has an exciting opportunity for an **Area Director of Clinical Reimbursement** . In this...RNACs and LNACs on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity… more
- WellSense (Boston, MA)
- …the Senior Vice President of Behavioral Health, the Senior Director of BH Clinical Programs oversees the BH Care Management, BH Utilization Management and ... Senior Director of BH Clinical Programs WellSense...with a minimum of 3 years' experience in a managed care setting . A minimum of...of 3 years' experience in a managed care setting . A minimum of 7years of progressive… more
- Providence (Burbank, CA)
- …in Coastal Service Area and San Fernando Valley Service Area. Transform delivery of clinical care - Develop and implement program strategies that will provide an ... customer experience. Thrive under new reimbursement models - collaborate with Finance and Managed Care to develop program strategies and partner with payers,… more
- AmeriHealth Caritas (Newtown Square, PA)
- ** Director Clinical Programs Excellence** Location: Newtown Square, PA Primary Job Function: Medical Management ID**: 34162 Your career starts now. We're looking ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and...of the VP Population Health Program Excellence, the Corporate Director of Population Health Clinical Program Excellence… more
- Sharp HealthCare (San Diego, CA)
- …and maintaining spreadsheets and databases. **What You Will Do** Under the direction of the Director of Managed Care Finance and Supervisor of Managed ... + Bachelor's Degree or equivalent work experience. + Previous experience in a managed care setting. + Working knowledge of hospital, physician and health… more
- Fallon Health (Worcester, MA)
- …a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon ... Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top...nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences,… more
- Prime Therapeutics (Columbus, OH)
- …meetings and for publication acceptance. **Responsibilities** + 7+ years of pharmacy, managed care and pharmaceutical industry experience. + At least 1-2 ... Strong interpersonal, consultation, organizational, tracking and follow-up skills. + Pharmacy, Managed Care , Pharmaceutical Industry experience. + Ability to… more
- Brookdale Senior Living (Brentwood, TN)
- … of Clinical Reimbursement is responsible for the oversight of Medicare/Medicaid/ Managed Care reimbursement and regulatory issues. This will role will ... Overview Brookdale seeks experienced Director of Clinical Reimbursement to support...skilled nursing communities. + Ensures that reimbursement structures are managed , evaluated, and capture accurate resource utilization at the… more
- FLACRA (Clifton Springs, NY)
- …modeling through maintaining a rotation of MDT participation, supervision, and covering gaps in clinical care as needed to help provide in the moment coaching to ... Senior Director of Clinical Operations Clifton Springs,...goals. This includes a strong emphasis on strengthening integrated care and care collaboration across the system.… more
- Access: Supports For Living (Middletown, NY)
- Clinical Director Location: Middletown, NY, United StatesDate Posted: Apr 19, 2024 Share: share to e-mail Apply Now Save JobSaved Description Location: ... Bonus: $7,500 Pay Rate: $90,000 Summary of Professional Functions : The Behavioral Health Clinical Director partners in the leadership of a fully care… more
- Gateway Hudson Valley (Kingston, NY)
- PROS Director of Clinical Services LCSW Job Details...and agency. + Provide continued education on changes to managed care + Provide an array of group ... experienced, Licensed Clinical Social Worker to fill key management position, Director of Clinical Services. This position is an essential member of… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Director , Clinical Account Services - Remote Nevada **Job Description Summary** Plays ... and improve care . Serves as facilitator and mentor to the clinical liaisons for assigned contract(s). Assists Account Managers with managing overall client… more
- Providence (Portland, OR)
- …satisfaction to patients, and their families, providers and employees. + \*The Clinical Director MAY perform the following essential functions in addition ... Leads managers and staff in the coordination and utilizes clinical best practices. Ensures patient care and...provide effective overall leadership in a rapidly changing competitive managed health care marketplace + Ability to… more
- Pacific Medical Centers (Seattle, WA)
- **Description** **Overview:** The director provides leadership for USFHP clinical operations: including care management and the clinical quality ... of experience in a managerial role within Pacific Medical Centers or a commercial managed care plan - Required **About Providence** At Providence, our strength… more