- 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 (Honolulu, HI)
- **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 (Concord, NH)
- …Information** Typically reports to an Associate Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Carson City, NV)
- …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 (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) - Oceanport,...as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment… more
- Centene Corporation (Queens, NY)
- …implementation and performance monitoring. The position will collaborate cross-functionally with corporate Service Fund and National Medicare contracting teams ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Billing Director -Patient Financial Services- Corporate (ON SITE) Full-Time -Days** Responsible for direction and management responsibility ... the business and operational activities of a department or medical care unit. **Qualifications** + 5 or more years...standards and billing regulations set by governmental agencies like Medicare and Medicaid. + May chair or participate in… more
- Humana (Baton Rouge, LA)
- …impact** Additional Information Typically reports to a Regional/Associate Vice President, Lead, or Corporate Medical Director , depending on size of region or ... 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
- 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
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …clear path toward Chief Medical Officer responsibilities\.** **This is more than a medical director role\. It's an opportunity to shape the future of care ... experienced clinical leader to join our team as Lead Medical Review Director -a pivotal role with a... necessity determinations are consistent with CMS published guidelines corporate medical review criteria, and medical… 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
- Integrative Emergency Services (Andalusia, AL)
- …ACLS + 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 Andalusia...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
- AmeriHealth Caritas (Philadelphia, PA)
- …quality improvement and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice ... ; **Responsibilities:** The Medical Director , Utilization Management provides organizational...3 years of utilization management experience in a Medicaid, Medicare , dual eligible or commercial health plan. + Minimum… more
- AdventHealth (Hendersonville, NC)
- …compliance with external accreditation standards, state and federal laws and Medicare conditions of Participation. The Director ensures administrative interface ... specialty shops, art galleries and unique restaurants The role you'll contribute: The Director manages the functions required to support the market-wide medical … more
- Ascendis Pharma (Princeton, NJ)
- …mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly ... develop their skills. Ascendis Pharma is looking to hire an experienced Director , Contract Operations to join our team. Responsibilities will include implementing… more