- Elevance Health (Tampa, FL)
- ** Medical Director - Florida Medicare ...and expectations for time onsite will be discussed as part of the hiring process. The health of our ... must reside in Florida near our Miami or Tampa locations.** The ** Medical Director ** will support the following Florida Medicare plans: Simply Healthcare… more
- CVS Health (Hartford, CT)
- …the US.** **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part C appeals (both provider and ... * Board Certified in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience. *… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... belief system.** We believe wellness and sickness are both part of a lifelong partnership, and that everyone could...This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities.… more
- Humana (South Miami, FL)
- …must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work ... **Become a part of our caring community and help us...The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,… more
- Cleveland Clinic (Cleveland, OH)
- …the Federal Clinical Trials Policy. In this role, you will report to the Director of Research Medicare Coverage Analysis and ensure compliant research billing ... the most respected healthcare organizations in the world. As a Research Medicare Coverage Analysis Specialist, you will be responsible for determining qualifying… more
- Community Health Systems (La Follette, TN)
- …+ 1-2 years of experience in understanding the minimum requirements needed for Medicare billing, medical claims processing, or hospital revenue cycle operations ... **Job Summary** The Medicare Billing Specialist is responsible for performing timely...physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the… more
- Henry Ford Health System (Traverse City, MI)
- …is required. GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 ... planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for both… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following ... SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Lincoln, NE)
- …to review Medicare drug appeals ( Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis ... of the Medicare rules, Humana policies and medical necessity. The Medical Director ...Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part… more
- Humana (Washington, DC)
- **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
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to ... 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 (Carson City, NV)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to ... 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 (Jefferson City, MO)
- …a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Bristol Myers Squibb (Washington, DC)
- …lead policy development and strategy related to drug pricing policy and legislation (eg IRA, Medicare Part D) for BMS as a member of a highly collaborative and ... Analyze legislative and regulatory developments impacting the IRA and Medicare Part D and develop BMS positions....should be directed to Chat with Ripley. R1598071 : Director , US Policy - Drug Pricing/ Part D… more
- CenterWell (Indianapolis, IN)
- **Become a part of our caring community and help us...the heart of everything we do. As an **Associate Medical Director (AMD) at CenterWell Senior Primary ... such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational...**Use your skills to make an impact** **The Associate Medical Director will be responsible for all… more
- CenterWell (Las Vegas, NV)
- …the lives of our patients, and the healthcare industry as a whole. The Associate Medical Director serves as a health-care professional and capable of handling a ... **Become a part of our caring community and help us...variety of health-related problems. The Associate Medical Director requires a solid understanding of… more
- Henry Ford Health System (Troy, MI)
- …Health Management AVP, Quality Improvement and Management Senior Director Medicare Stars, HEDIS, and Reporting HAP Medical Directors Vice Presidents ... The HAP Medical Director represents the plan and...within Pharmacy, Strategic Development, Provider Relations Vice President, Medicare /MMP Operations Various HFHS Executives/Clinical Leaders and non-HFHS network… more
- Gentiva (Milwaukee, WI)
- …Hospice and Palliative Medicine board certification and/or Hospice Medical Director Certification Board certification preferred. + Current Medicare Provider ... Transform Care through Compassionate Hospice Leadership.** We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert… more
- American Medical Association (Washington, DC)
- …Lobbyist, Director I (Hybrid) Washington, DC (Hybrid) The American Medical Association (AMA) is the nation's largest professional Association of physicians and ... and the promise of a healthier nation. To be part of the AMA is to be part...corporate offices in Washington DC for a Regulatory Lobbyist, Director I (Hybrid)on our Advocacy team. This position can… more
- Centene Corporation (Jefferson City, MO)
- …IRE and ALJ hearings, STARS metrics + Previous experience with ensuring high quality medical director training to review Medicare UM and appeals, Clinical ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
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