- Elevance Health (Columbus, OH)
- ** Medicare Medical Director ** Location:...Director Associates. May be responsible for an entire clinical program. **How you will make an impact:** + ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...external committees. + May chair company committees. + Interprets medical policies and clinical guidelines. + May… more
- Molina Healthcare (Columbus, OH)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. ... + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical … more
- CVS Health (Hartford, CT)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary ... of experience in a Health Care Delivery System eg, Clinical Practice or Health Care Industry * Medical...Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance &… more
- Centene Corporation (Jefferson City, MO)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... including a fresh perspective on workplace flexibility. + **Position Purpose:** Assist the Medicare Chief Medical Officer to develop and implement our enterprise… more
- Humana (Columbus, OH)
- …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 problems of diverse...represents Humana at Administrative Law Judge hearings; exercises independent clinical judgment and decision making on complex issues regarding… more
- Humana (Columbus, OH)
- …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 problems of diverse...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Centene Corporation (Queens, NY)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is...position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …providing analytic support to help identify the most efficient means through which Medicare Stars clinical quality and patient experience performances at BCBSMA ... Scientist supports analytic activities associated with BCBSMA overall performance on Medicare Stars ratings, with specific focus on CAHPS patient experience… more
- Centene Corporation (Providence, RI)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... Payment Initiatives (VBP) will support the expansion and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The VP Medical Director of Clinical Programs will manage the Health Plan ... Medical Directors and, as a Medical Director team, provide clinical ...Contributes to and advises in product design and the Medicare bid processes + Contributes to and advises in… more
- Aveanna Healthcare (Needham, MA)
- Clinical Director (RN) ApplyRefer a FriendBack Job Details Requisition #: 204884 Location: Needham, MA 02492 Category: Nursing Salary: $100,000.00 - $110,000.00 ... per year Position Details Position Overview The Clinical Director is responsible and accountable for...or without notice. Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- ChenMed (St. Petersburg, FL)
- …transitional position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical ... simultaneously completing PCP Black Belt Training and Mastering the Medical Director Essentials within a combined and...CAHPS and net promoter score (patient experience), HEDIS and clinical gaps closures, and medical cost effectiveness… more
- Genesis Healthcare (Franconia, NH)
- …therapists, consideration of clinical requirements, and recommendations from the Clinical Director . 12. Administers financial controls of revenue and ... place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time...with licensed therapists, the Clinical Operations Area Director and the Clinical Director .… more
- Aveanna Healthcare (Indianapolis, IN)
- Clinical Director - RN - Home Care ApplyRefer a FriendBack Job Details Requisition #: 200527 Location: Indianapolis, IN 46214 Category: Nursing Salary: ... you when you come to Aveanna. Position Overview The Clinical Director is responsible and accountable for...or without notice. Vaccination Requirements As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Aveanna Healthcare (Tampa, FL)
- RN Clinical Director ApplyRefer a FriendBack Job Details Requisition #: 204579 Location: Tampa, FL 33607 Category: Nursing Salary: $78,000.00 - $82,000.00 per ... year Position Details Position: Clinical Director (RN) ( Director of...children, adolescents, and/or adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with… more
- Genesis Healthcare (Salinas, CA)
- …with all regulatory and practice act requirements with input from Clinical Director /lead clinician. 3. Operationally manages Powerback Rehabilitation personnel ... place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time...of clinical requirements, and recommendations from the Clinical Director and/or lead clinician. 8. Administers… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- ChenMed (St. Louis, MO)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... great people to join our team. The Associate Market Clinical Director will directly supervise, performance manage...to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model,… more
- Aveanna Healthcare (Palmdale, CA)
- RN Clinical Director - Home Health ApplyRefer a FriendBack Job Details Requisition #: 204893 Location: Palmdale, CA 93550 Category: Nursing Salary: $90,000.00 - ... $95,000.00 per year Position Details Position Overview TheRN Clinical Director is responsible and accountable for...and Employees Residing in California As an employer accepting Medicare and Medicaid funds, employees must comply with all… more