- Humana (Columbus, OH)
- …the courage to innovate + **Resides in KY** **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- CVS Health (Springfield, IL)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California,...Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from… more
- CVS Health (Frankfort, KY)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... Better Health of Kentucky primarily, and the Southeast Region (FL, LA and WV). This Medical Director will be a "Work from Home" position primarily supporting the… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- ChenMed (Richmond, VA)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
- Teva Pharmaceuticals (Hartford, CT)
- Director Federal Accounts & Medicaid (V&A) Date: May 15, 2025 Location: Hartford, United States, Connecticut, 06103 Company: Teva Pharmaceuticals Job Id: 61986 ... are met on an annual basis. As well, the Director is responsible for providing Medicaid specific...account, leveraging cross-functional teams (to include Pricing & Contracting, Medical , Value & RWE as appropriate) ⦁ Collaborate with… more
- Humana (Madison, WI)
- …responsible for all growth-related initiatives and communications to iCare and Inclusa Medicaid products. The Associate Director , Market Development requires a ... first** Become a part of our dynamic Wisconsin leadership team as the Associate Director , Market Development. The Associate Director , Market Development, is… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Attorney General, Office of the Title Legal Nurse/ Medical Analyst: Medicaid Fraud Control Unit (6388) Occupational Category Legal Salary Grade ... Justice Division Medicaid Fraud Control Unit - New York City Medical Analyst, Opportunity for Registered NursesReference No. MFCU_NYC_ MA_6388Salary is $80,537 +… more
- State of Colorado (Denver, CO)
- …protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries. + To hold individuals accountable ... Medicaid Fraud Investigator (Special Agent III) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4925752)...cases from intake to completion; + Experience working with medical records and bank records during the course of… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …of large and complex Medicaid program(s) and supervision exercised. Differs from Medicaid Deputy Director by the absence of responsibility for the day-to-day ... of Medicaid Application Centers + Disability determinations made by Medical Eligibility Determinations Team (MEDT) + Coordinating Refugee Medical Assistance… more
- Humana (Columbus, OH)
- …health first** Humana Healthy Horizons is a seeking a Senior Project Manager ( Medicaid Network Implementation) who is accountable for working with the Director , ... driving efficient management of end-to-end provider-related functions in new Medicaid market implementations. The Senior Project Manager makes decisions supporting… more
- Abbott House (Bronx, NY)
- …+ Oversees all business functions + Perform other secretarial duties as requested by Medical Director . + Any other related duties as required Educational & ... Job Summary: The Medicaid Managed Care Liaison is the primary contact...Oversee and support program audits + Responsible for closed medical records + Arrange Single Case Agreements with out… more
- Northwell Health (Staten Island, NY)
- …or their representative. + * Determines patient's potential eligibility for Medicaid and completes application in accordance with departmental policies and ... procedures. + * Follows up all incomplete patient's Medicaid applications either by verbal or written contract as required. + * Records and updates all Medicaid … more
- Centene Corporation (Dover, DE)
- …and Supports (LTSS) and Medicare- Medicaid Duals populations. Additionally, the Medical Director will collaborate with other key stakeholders to provide ... with the LTSS Director and Care Coordination Director to manage and optimize LTSS and Medicare- Medicaid...LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO)… more
- State of Colorado (Denver, CO)
- …Department of Health Care Policy and Financing (Department), including the Colorado Medical Assistance Program ( Medicaid ) and the Colorado Children's Basic ... Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4941547) Apply Fraud Waste and Abuse Division … 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This is a remote based, work ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- City of New York (New York, NY)
- Job Description The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying ... the Reimbursement Division, is responsible for determining consumer eligibility for Medicaid reimbursements of out-of-pocket medical expenditures and for the… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTATIVE DIRECTOR OF SOCIAL SERVICE CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR ... CHANGE. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to...Services Program (HCSP) is recruiting for one (1) Administrative Director of Social Services NM II, to function as… more
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