- Elevance Health (Metairie, LA)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...specific position is $125,118 to $214,488. Prorated based on part -time hours. Locations: Illinois, Washington DC, New York In… more
- CVS Health (Hartford, CT)
- …US.** Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary on the non-regulated appeals team, ... encumbrances * Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience.… more
- Humana (Columbus, OH)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Columbus, OH)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Scientist supports analytic activities associated with BCBSMA overall performance on Medicare Stars ratings, with specific focus on CAHPS patient experience ... to help identify the most efficient means through which Medicare Stars clinical quality and patient experience performances at...into a cohesive view. Under direction of the Senior Director of Population Health Analytics, the Data Scientist will… 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
- 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
- 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- CenterWell (Jacksonville, FL)
- **Become a part of our caring community and help us put health first** The Associate Medical Director has similar job duties as a Physician, namely focusing ... of care, health maintenance, and disease prevention. The Associate Medical Director is also responsible for administrative...+ This role is considered patient facing and is part of our Tuberculosis (TB) screening program. If selected… more
- State of Colorado (Denver, CO)
- Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4941547) Apply Fraud Waste and Abuse Division ... Director Salary $103,644.00 - $165,840.00 Annually Location Denver Metro,...responses from people of diverse backgrounds and abilities. As part of the State of Colorado, HCPF offers a… more
- Beth Israel Lahey Health (Charlestown, MA)
- …hospitals, outpatient facilities, physician groups, performance networks, and community partners. As part of the leadership team, the Director will assist the ... revenue analysis. Working with the VP and AVP, the Director will develop long- and short- term Medicare...processes and tools to optimize appropriate transplant program and medical education reimbursements, with a focus on harmonizing across… more
- Evolent (Columbus, OH)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Mount Sinai Health System (New York, NY)
- …environments * Seek to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible ... to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- Evolent (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Providence (Santa Rosa, CA)
- …and execution of strategic growth priorities and business plans for OC/HD Medicare initiatives in collaboration with the Senior Director of Individual ... presentation, and verbal). + **Market Knowledge:** Deep understanding of the California Medicare Market, including Brokers, MCOs, health plans, Medical Group,… more
- Elderwood (Lake Placid, NY)
- …regulations that govern the facility, and as may be directed by the Administrator, the Medical Director , and/or Director of Nursing, to ensure that the ... Salary $82,368 - $105,310 / year Overview Assistant Director of Nursing Pay Rate Range: $82,368 -...with experience! NEW, Gas Allowance Benefit for Full and Part -time positions! Elderwood of Uihlein at Lake Placid is… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …does not manage people + This role reports to this job: SENIOR MEDICAL DIRECTOR (MGR) + Necessary Contacts: department Managers, Authorization, Utilization ... external accreditation bodies; JCAHO, URAC, or NCQA preferred + Medicare Advantage experience is preferred **Skills and Abilities** +...is allowed by a relevant jurisdiction, according to the medical director or clinical director ,… more
- Trinity Health (Urbandale, IA)
- …Summary: In Accordance with the Trinity Health at Home (THAH) Mission, The Hospice Medical Director will be responsible for the overall medical direction ... of patient and family services. The Hospice Medical Director will work with the...provide education to the Interdisciplinary Team members according to Medicare guidelines. * Maintain a regular schedule of participation… more
- Evolent (Columbus, OH)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… 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 ... Programs and other areas of MHPC, as needed + Assists the Market Medical Director for building and deepening relationships with area hospitals, physicians,… more