- Atrium Health (Charlotte, NC)
- …knowledge and understanding of severity based DRG systems; All-Patient Refined and Medicare Severity (APR-DRG), Medical Severity Diagnostic Related Group System ... quality and completeness of clinical documentation within the patient electronic medical record using a multidisciplinary team process. Exhibits expertise associated… more
- BAYADA Home Health Care (York, PA)
- **Hospice Medical Director Opportunity** BAYADA Hospice provides the highest quality end-of-life care so our patients can remain at home with comfort, grace, and ... of life. We are currently hiring a part time Medical Director to join our team of...services rendered in accordance with policies and procedures and Medicare rules + Serve as a key medical… more
- The Cigna Group (Birmingham, AL)
- **_LOCATION: Hybrid/ Remote position aligned to the Tri-South Alabama/Mississippi Market. Must live in either Alabama or Mississippi._** The **Manager, Provider ... member of the Provider Contracting Team and reports to the Provider Contracting Director . This role assists in developing the strategic direction and management of… more
- Centerwell (Columbus, OH)
- …Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead comprehensive clinical ... optimization and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare **Use your… more
- Martin's Point Health Care (Portland, ME)
- …of Medicare Risk Adjustment initiatives and operations. The Senior Director is also responsible for all aspects of the decision-making and implementation ... Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan...of medical record coding reviews and coding policies for the… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- PharmD/RPH required- REMOTE **Job Description ... Summary** Responsible for support and development of Medical Pharmacy program strategy as part of the Medical Pharmacy Business Development team. Responsible for… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Associate Director , SIEM & Detection Engineering oversees the SIEM engineering, alerting and detection ... well as other enterprise information security teams. Job Description The **Associate Director , SIEM & Detection Engineering** role is responsible for the strategic… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Associate Director of the Tier 1 SOC is a critical role in our organization, responsible for ... level of technical expertise, strategic thinking, and leadership abilities. The Associate Director will oversee the tier 1 SOC (MSSP) providing 24x7x365 coverage,… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote . The role requires a broad knowledge and focus ... utilization management, industry benchmarks, demonstrated regulatory requirement experience and medical necessity criteria. The role requires the ability to… more
- VIP Care (Tampa, FL)
- Summary/Objective: The Senior Medical Director is responsible for leading efforts to develop and implement medical management and performance improvement ... strategies to ensure success in our existing ( Medicare Advantage) as well as net new LOBs. They...utilization and provide better health for patients. The Senior Medical Director would also leverage their entrepreneurial… more
- Medical Mutual of Ohio (Brooklyn, OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. The Clinical Operational… more
- WellSense (Boston, MA)
- …in collaboration with the Senior Director of Strategy and Operations, the BH Medical Director , the Senior Vice President of BH to determine the most ... Senior Director of BH Clinical Programs WellSense Health Plan...company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25… more
- MetroLink (Los Angeles, CA)
- Director , Design (Limited Term) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4458277) Apply Director , Design (Limited Term) Salary ... Annually Location California 91767, CA Job Type At Will Full Time Remote Employment Flexible/Hybrid Job Number 23-2400105 Department Standards & Design Opening Date… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** Research Billing Support **Work Type:** Full Time (Total ... 8 Hr (8:00:00 AM - 4:30:00 PM) **Summary:** Reporting to the Director /Manager of Clinical Trials Research Revenue Cycle, this position will create coverage… more
- MetroLink (Los Angeles, CA)
- Director , Program Management Oversight Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4290792) Apply Director , Program Management Oversight ... Annually Location California 91767, CA Job Type At Will Full Time Remote Employment Flexible/Hybrid Job Number 23-2400087 Department Program Management Opening Date… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- Provides clinical leadership and serves as an internal medical consultant to various divisions and committees to support the development, implementation and ... monitoring of medical management and quality improvement activities\. **Job Description:** **Job...interpret and explain complex government policies + Knowledge of Medicare programs **Job Specific Requirements:** Medicare experience… more
- Organon & Co. (Olympia, WA)
- **Job Description** **The Position** The Director , Government Public Policy will report to the Chief Government Affairs and Policy Officer, working directly with the ... General Counsel's office to accomplish meaningful priorities and goals. The Director will pursue solutions-oriented approaches to healthcare policy analysis and… more
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Director - Hospital Pharmacy Services - Marshfield Medical Center **Cost Center:** ... Shift:** 40 Normal (United States of America) **Job Description:** **JOB SUMMARY** The Director of Hospital Pharmacy Services is an integral member of the Division… more
- Elevance Health (Waukesha, WI)
- …Health location. Work schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and implementing ... **This is a remote , individual contributor role and the person in...clinical programs with specific medical condition focus for all lines of business enterprise… more
- NASCO (Columbus, OH)
- **Overview** Under general direction, the Executive Director , Compliance will lead and provide oversight and management of Compliance and Privacy functions and serve ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
