• Aveanna Healthcare (Madison, WI)
    ** 20% Incentive Plan ** Position Overview The Area Executive Director (AED) is responsible for the administrative, operational, and leadership oversight of a ... branches and operational leadership. Essential Job Functions The Area Executive Director is responsible for directly managing all essential operational and… more
    job goal (12/19/25)
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  • Aveanna Healthcare LLC (Brookfield, WI)
    …to provide supervision of all clinical staff working with high medical acuity clients and/or clients receiving extended nonlicensed support services. This ... Ensures that services are delivered according to licensing guidelines, professional medical standards and agency policies and procedures. Essential Job Functions:… more
    job goal (12/19/25)
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  • The Goodkind Group, LLC (Melville, LA)
    …Billing Insurance Follow-up Supervisor to work for a rapidly growing medical management company in the Farmingdale/Melville area. This position REQUIRES three ... years of Insurance Follow-up, multi-specialty experience, and knowledge of Medicare, Medicaid and Government HMO insurance follow-up. As the Supervisor - Insurance… more
    job goal (12/23/25)
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  • Behavioral Health Medical Director

    Elevance Health (Indianapolis, IN)
    **Behavioral Health Medical Director - Psychiatrist - Indiana Medicaid ** **Location:** This role enables associates to work virtually full-time, with the ... will reside in Indiana. Alternate locations may be considered. The **Behavioral Health Medical Director ** is responsible for reviewing cases for IN Medicaid more
    Elevance Health (12/05/25)
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  • Medical Director Associate-…

    Elevance Health (Seven Fields, PA)
    ** Medical Director Associate- Psychiatrist- Pennsylvania Medicaid ** **Location:** This role enables associates to work virtually full-time, with the ... granted as required by law. Alternate locations may be considered. The ** Medical Director Associate** is responsible for providing day-to-day guidance, support,… more
    Elevance Health (12/24/25)
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  • Medical Director - Medicaid

    Humana (Baton Rouge, LA)
    **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 (12/07/25)
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  • Medical Director - Medicaid

    CVS Health (Madison, WI)
    …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 Oklahoma. This UM (Utilization Management) Medical Director will be a "Work from… more
    CVS Health (12/19/25)
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  • Associate Market Medical Director

    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
    ChenMed (10/21/25)
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  • Clinical Psychologist - BCBA/BCBA-D

    CVS Health (Baton Rouge, LA)
    …effective utilization of health care resources. Reporting to the Executive Behavioral Health Medical Director , Aetna Medicaid , this role is responsible for ... and guidance to the ABA prior authorization clinical team and health plan medical directors. * Attend and actively participate in clinical meetings with care… more
    CVS Health (11/13/25)
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  • Medicaid Contract Implementation Management…

    Elevance Health (Indianapolis, IN)
    ** Medicaid Contract Implementation Management Director ** **Location** : Indianapolis, IN **Hybrid 2:** This role requires associates to be in-office 3 days per ... for employment, unless an accommodation is granted as required by law._ The ** Medicaid Contract Implementation Management Director ** is responsible for managing … more
    Elevance Health (12/19/25)
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  • Associate Director , Product Marketing…

    Humana (Albany, NY)
    …put health first** Humana's Marketing organization is seeking an Associate Director , Product Marketing to lead the go-to-market, positioning, and member-focused ... campaigns for our Medicaid lines of business. You will craft the product...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (12/23/25)
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  • Capture Director , Medicaid

    CVS Health (Richmond, VA)
    …we do it all with heart, each and every day. **Position Summary** Aetna's Medicaid Capture Director role leads strategy and capture planning activities in ... as necessary to meet deadlines - 7+ years of experience leading and driving Medicaid managed care proposals. - Capture management experience in Medicaid managed… more
    CVS Health (12/16/25)
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  • Oklahoma Medicaid Market CFO

    Humana (Oklahoma City, OK)
    …part of our caring community and help us put health first** The Oklahoma Medicaid Market CFO analyzes and forecasts financial, economic, and other data to provide ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
    Humana (11/19/25)
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  • Medicare/ Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical... Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims, settlement,… more
    Commonwealth Care Alliance (11/25/25)
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  • Medicaid Managed Care Liaison

    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
    Abbott House (11/20/25)
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  • Administrative Law Judge II / General Services…

    State of Colorado (Denver, CO)
    …Law Judge II / General Services or Medicaid - Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5163552) Apply  Administrative ... Law Judge II / General Services or Medicaid - Hybrid Salary $91,272.00 - $121,770.00 Annually Location...process may request a review by the State Personnel Director . As an applicant directly affected by the results… more
    State of Colorado (12/10/25)
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  • Medical Director - IP Claims…

    Humana (Raleigh, NC)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
    Humana (12/11/25)
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  • Senior Utilization Review Medical

    Integra Partners (Troy, MI)
    The Senior Medical Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is ... require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads medical more
    Integra Partners (12/03/25)
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  • Utilization Review Medical Director

    Integra Partners (Troy, MI)
    The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with… more
    Integra Partners (12/02/25)
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  • Medical Director -Payment Integrity

    Humana (Carson City, NV)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
    Humana (12/11/25)
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