- Signature HealthCARE (Nashville, TN)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... in care and quality of life for each resident. Provide oversight and guidance to staff in all facilities...enhance our resident care and outcomes. Schedule company-wide Quality Performance surveys based on program requirements with segment teams.… more
- Cambia Health Solutions, Inc (Portland, OR)
- Director Government Programs Compliance Officer Work a Hybrid Schedule from Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a ... care system. Who We Are Looking For: Every day, Cambia's dedicated team of Director Government Programs Compliance Officer is living our mission to make health care… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …care. Contributes to the provision of quality nursing care through performance improvement processes that demonstrate positive outcomes in patient care. Provides ... care. Contributes to the provision of quality nursing care through performance improvement processes that demonstrate positive outcomes in patient care. Provides… more
- University Medical Center of El Paso (El Paso, TX)
- Job Summary The Director of Strategy Planning and Decision Support is responsible to spearhead El Paso Health's (EPH) strategic planning and to provide ... UMC's Decision Support processes. Focuses on strategies to position the Medicaid and Medicare Managed Care Organization (MCO) in the El Paso and Hudspeth Region.… more
- CVS Health (Lansing, MI)
- …We are seeking an Executive Director to lead the newly formed **Group Medicare Performance Optimization** team. This leader will preside over performance ... trends while working collaboratively with business partners to drive performance improvements. This leader will also provide ...annual operating plans and work across the Aetna and Medicare organizations to assess performance , define clear… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director , and ... is responsible for the financial and operational activities of provider networks and this position involves extensive interaction with...interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of… more
- Humana (Columbus, OH)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid requirements, and… more
- The Cigna Group (Atlanta, GA)
- …Operations Senior Manager or Director , this individual ensures the effective performance management of the provider network for his/her assigned sub-market ... work from local office 3 days per week.** The Provider Performance Enablement Advisor is an integral...members contribute to the growth and profitability of the Medicare Advantage business in their market in the following… more
- The Cigna Group (Maitland, FL)
- …Contracting, Provider Relations, and Network Development & Solutions). Reporting to the Provider Performance Director , the Provider Performance ... to travel between Tampa, Orlando, Jacksonville.** **Role Summary** The Provider Performance Manager is a key member...members contribute to the growth and profitability of the Medicare Advantage (MA) business in their market in the… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …true colors to blue. Reporting to the SVP, Sales & Client Management, the Director , Group Medicare Sales, is an integral member of the leadership team-driving ... management team to develop strategies that shape BCBSMA's overall direction in Medicare , achieve the company's performance goals and deliver an exceptional… more
- The Cigna Group (Bloomfield, CT)
- …Medicare Advantage position** WORK LOCATION: REMOTE position The **National Ancillary Medicare Advantage (MA) Provider Contracting Senior Advisor** is a ... contracts including clinical programs, MA Supplemental benefits, and direct provider agreements. This role operates at a strategic level...NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment.… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and ... ensure program compliance with governing bodies' regulations, including the Center for Medicare and Medicaid Services. This role will partner with leadership to… more
- CVS Health (Hartford, CT)
- …cubes, HCIC (health care information center), curation of a network, and overall provider performance . + Participating in state specific RFP conversations. + ... ways every day. Aetna is recruiting for an Executive Director , Actuarial who will be responsible for understanding and...will be responsible for understanding and driving action on Medicare Network Insights and curating support for this important… more
- Healthfirst (NY)
- …+ Develop, monitor and coach Sales Managers while Sales Mangers achieve overall performance . Must provide diligent supervision on Sales Managers ability to ... + Direct all prospect and sales activities for Medicare products for a specified geographic area. +...mentor, and develop staff; oversee new employee onboarding and provide career development planning and opportunities for growth +… more
- CVS Health (Hartford, CT)
- …health care more personal, convenient and affordable. **Position Summary** The Lead Director , Project Program Management will lead a cross-functional team focused on ... delivering large, complex strategic initiatives for the Medicare Organization. In a matrix management capacity, you... Organization. In a matrix management capacity, you will provide leadership and strategic direction to a team of… more
- GEHA (Lee's Summit, MO)
- …sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will report to the Director of Pharmacy and will ... Offering one of the largest medical and dental benefit provider networks available to federal employees in the United...+ Work in conjunction with the Vice President and Director of Pharmacy to align Medicare Part… more
- The Cigna Group (Nashville, TN)
- …to financial, affordability, growth and quality performance targets for Cigna Medicare . Negotiate and contract provider service and vendor agreements and ... stakeholders for complex value-based and downside risk reimbursement methodologies for Medicare provider contracting matters. + Initiates and maintains effective… more
- Humana (Tallahassee, FL)
- …for the development, implementation, and management oversight of the company's Medicare /Medicaid Stars Program. The Associate Director , Stars Improvement, ... associates. **Responsibilities** + Develop and implement strategies for clinical provider engagement statewide based on HEDIS/Quality performance measures… more
- Martin's Point Health Care (Portland, ME)
- …a "Great Place to Work" since 2015. Position Summary The position of Senior Director , Member and Provider Services is responsible for the success and oversight ... Plan lines of business. In this role the Senior Director , Member and Provider Service will plan...operational efficiencies; and continued compliance with our Centers for Medicare and Medicaid Services (CMS) and Department of Defense… more
