- Humana (Louisville, KY)
- …deliver improved health outcomes, optimized cost performance and measurable program value across Medicaid . This executive leverages advanced analytical, data ... **Medical Economics:** + Lead medical cost analysis, premium analytics, and program effectiveness initiatives for Medicaid products. + Oversee the creation… more
- State of Colorado (Denver, CO)
- …Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program ), Child Health Plan Plus (CHP+), and other state public ... role provides leadership on behavioral health matters to the Executive Director and Medicaid Director. The Senior Advisor collaborates closely with other subject… more
- Elevance Health (Indianapolis, IN)
- …cost , and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care ... **Behavioral Health Medical Director - Psychiatrist - Indiana Medicaid ** **Location:** This role enables associates to work virtually full-time, with the exception… more
- CVS Health (Frankfort, KY)
- …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, California, Florida, Illinois, ... working at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a Plus **Preferred Qualifications:**… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …requirements while ensuring high levels of healthcare quality and acceptable levels for the cost of care. 3. The Physician Advisor will conduct clinical reviews ... physician with leadership experience interested in our new Physician Advisor position. 1. The Physician Advisor serves...the segmentation of concurrent review offerings into Medicare / Medicaid / Commercial Payors, as needed * Reviews medical… more
- HCA Healthcare (Salem, VA)
- …you want to join an organization that invests in you as a Patient Customer Advisor ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... medical coverage that covers many common services at no cost or for a low copay. Plans include prescription...student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program … more
- State of Colorado (Denver, CO)
- …Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program ), Child Health Plan Plus (CHP+), and other state public ... federally recognized single state agency to administer the Colorado Medicaid program of health care coverage for...working towards the Department's mission to improve access to cost -effective, quality long term care services and supports for… more
- OhioHealth (Columbus, OH)
- …of value-based models to deliver on the value equation of quality, service, and cost efficiency. This position reports to the Advisor , Value Based Contract ... team-building sessions to foster growth, development, and team effectiveness. 30%: Medicare, Medicaid , and commercial program knowledge . Analyze and communicate… more
- Waystar (Atlanta, GA)
- …& FinOps** + Continuously monitor and optimize AWS infrastructure costs using AWS Cost Explorer, Trusted Advisor , and Savings Plans/Reserved Instances. + Drive ... across compute, storage, databases, networking, and security, combined with strong cost optimization strategies. The AWS Cloud Architect will help define the… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for all enterprise quality performance programs across the organization's Medicare, Medicaid , ACA, and Commercial lines of business. This position leads the ... to members. The Director serves as a visible leader and trusted advisor to executive leadership, driving enterprise collaboration to achieve quality excellence. Your… more
- Houston Methodist (Houston, TX)
- …plan of care and services provided are patient-focused, high-quality, efficient, and cost -effective. Serves as a preceptor and implements staff education specific to ... continued stay, and resource use, appropriate level of care and program compliance. Identifies when services no longer meet evidence-based criteria, initiates… more
- Huron Consulting Group (Chicago, IL)
- …clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and ... to achieve appropriate length of stay and level of care, while promoting cost -effective and quality patient care. Position is located in Annapolis, MD + Staff… more
- New York State Civil Service (Albany, NY)
- …through collaborative review and utilization of available data.* Serve as physician advisor to OPWDD Medical Directors and lead clinician when collaborating with ... of care expectations.* Serve as OPWDD's Medical Director of the Naloxone program .* Conduct ongoing review of OPWDD agency-wide policies and procedures.* Participate… more
- Houston Methodist (The Woodlands, TX)
- …care and services provided are patient-focused, high quality, efficient, and cost -effective; facilitates timely: - completion and reporting of diagnostic testing; - ... admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Millman l criteria,… more
- Houston Methodist (The Woodlands, TX)
- …of care and services provided are patient-focused, high quality, efficient, and cost -effective. + Serves as a preceptor and implements staff education specific to ... admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Milliman l criteria,… more
- Grifols Shared Services North America, Inc (Minneapolis, MN)
- …territory including major accounts and large players (ie, Commercial, Medicare, and Medicaid ) *Understanding of Hospital formulary with guidance of RSD and NAM/NAD ... customers. *Become a valued strategic partner as well as trusted advisor offering customer-centric solutions. Consistently demonstrate follow-through for the benefit… more