• Medical Director , LTSS (must…

    AmeriHealth Caritas (Newark, DE)
    ** Medical Director , LTSS (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: 34195 **Job Brief** Qualified ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical Directors, Utilization Management and… more
    AmeriHealth Caritas (05/09/24)
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  • Senior Medical Director - Medicaid…

    CVS Health (Hartford, CT)
    …make health care more personal, convenient and affordable. Job Purpose and Summary: The LTSS /SAI National Senior Medical Director , reporting to a Regional ... closely with data analytics team and develops specific actions to manage LTSS related medical cost trends* Develops benchmarks for LTSS clinical staff… more
    CVS Health (04/04/24)
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  • Director Long-Term Services and Support

    CVS Health (Tampa, FL)
    …business strategies are delivered and financial, compliance and quality objectives are met. The LTSS Director will partner closely with the LTSS Executive ... and affordable. Position Summary The Long-Term Services and Support ( LTSS ) Director will partner closely with the...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
    CVS Health (05/25/24)
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  • Director - Community Health Partnership

    Open Sky Community Services (Worcester, MA)
    …(CCHP/BH) Community Partners Program and CCHP's Long Term Services and Supports (CCHP/ LTSS ) Community Partner Program. The Director will supervise the ... health and wellness a reality, not a dream. The Director of the Central Community Health Partnership will provide...build and enhance relationships with partner agencies along with medical and behavioral health agencies in support of the… more
    Open Sky Community Services (06/18/24)
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  • Medical Director Case Management

    CVS Health (Hartford, CT)
    …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... physical, behavioral and socioeconomic needs.* Partner closely with the Executive Director of Duals and other Duals Care Management leadership to collaborate… more
    CVS Health (05/05/24)
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  • Senior Medical Director

    CVS Health (Columbus, OH)
    …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... as needed. * Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
    CVS Health (04/13/24)
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  • Director , Quality & Control Assurance…

    Commonwealth Care Alliance (Boston, MA)
    **Why This Role is Important to Us:** **Position Summary:** The Director , Quality & Control Assurance reports to the VP of Quality & Control Assurance is responsible ... Medicare Risk Adjustment, HCC, clinical and coding reviews; DRG and medical records reviews; technology/systems and coding upgrade and implementation reviews (eg… more
    Commonwealth Care Alliance (05/15/24)
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  • Field Service Coordinator

    Humana (Columbus, IN)
    …+ Assisting members in maintaining Medicaid eligibility + Collaborate with Medical Director /Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, ... include: + Administer initial and ongoing long-term services and support ( LTSS ) related assessments through person-centered thinking approaches. + Contacts members… more
    Humana (05/31/24)
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  • Provider Services Advisor (Medicaid)

    Humana (Indianapolis, IN)
    …of the Provider Services team. The Provider Services Advisor will advise the Director , Provider Services, on the day-to-day and strategic operations of the team, ... significance. The Provider Services Advisor responsibilities include: + Advises Provider Services Director on strategic and day to day operations of the overall… more
    Humana (06/23/24)
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  • Registered Nurse

    Greater Lynn Senior Services (Lynn, MA)
    …scheduled hours of work you may be eligible for: + Hybrid work schedule + Medical and Dental insurance + Health Spending Account + Flexible Spending Accounts (FSA) - ... referral bonuses of up to $1,000 Position Overview: The LTSS Program Clinical Care Nurse will complete program Comprehensive...The NRLP Clinical Care Nurse will support the Program Director in day to day operations of the program.… more
    Greater Lynn Senior Services (05/22/24)
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  • Supervisor Case Manager Long-term Care - RN (Kent…

    Highmark Health (Dover, DE)
    …facilities and providers for care-coordination. + Participate in rounds with the Medical Director . + Review documentation and processes for consistent practice, ... and to promote effective use of resources for members enrolled in DSHP Plus LTSS . Provides direct oversight to Case Managers, meets all of the requirements of a… more
    Highmark Health (04/26/24)
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