- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. + **Position Purpose:** Assist the Medicare Chief Medical Officer to develop and implement our enterprise ... executives and the ROI behind clinical initiatives. Must understand Medicare and Medicaid, prior Health plan experience is a... medical directors. + Utilize the services of medical and pharmacy consultants for reviewing complex… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… 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...LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO)… 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, CO Job Type Full Time Job Number UHA01380 03/08/2025 Department Department of Health Care… more
- RWJBarnabas Health (Oceanport, NJ)
- …strategies across all RWJBarnabas Health hospitals. This includes planning, preparing and reviewing of the annual Medicare /Medicaid cost reports filings. In ... partnership with the Vice President of Corporate Reimbursement, the Director will manage the completion of DSH, Medicare...and financial health. + Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Dental and Vision… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons...medical issues and departmental responsibilities. Assists in monitoring, reviewing , and evaluating the quality of health care services… more
- New York State Civil Service (Syracuse, NY)
- NY HELP Yes Agency Mental Health, Office of Title Assistant Director of Nursing 1 Psychiatric- Inpatient (NY HELPS), Hutchings Psychiatric Center, P26078 ... of Mental Health (OMH) Joint Commission accredited hospital, is recruiting an Assistant Director of Nursing 1, Psychiatric (ADON) to serve as the Inpatient Assistant… more
- New York State Civil Service (Syracuse, NY)
- …compliance.* Ensuring that nursing chart notes, treatment plans are appropriate, and medical tracking is completed. * Reviewing and completing performance ... NY HELP Yes Agency Mental Health, Office of Title Assistant Director of Nursing 1 Psychiatric- Quality, Education, and Training (NY HELPS), Hutchings Psychiatric… 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
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has overall accountability for ... of the Quality Management/Utilization Management (QM/UM) Plan, including having the BH Medical Director for Children's Services and participate on the BH… more
- Intermountain Health (Murray, UT)
- **Job Description:** The Medical Director of the Liver Transplant Program and Hepatology Director for Hospital is designed to assist the Hepatology Division ... education, and research. **Leadership** Work collaboratively with the Program and medical staff leaders, Hospital managers, and supervisors, as well as specialists… more
- Molina Healthcare (Spokane, WA)
- …and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient ... activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and communicating resolution to members or authorized… more
- Banner Health (Phoenix, AZ)
- …Clinical Decision Making **Work Shift:** Day **Job Category:** Physicians The Senior Medical Director , Network Performance is a senior clinical executive ... leadership, enterprise collaboration, and credible clinical engagement, the Senior Medical Director will ensure Banner's network strategy consistently… more
- HCA Healthcare (Orlando, FL)
- …We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Director of Reporting - Orlando opening. Qualified ... join an organization that invests in you as a Director of Reporting - Orlando? At HCA Healthcare, you...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- HCA Healthcare (Nashville, TN)
- …We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Director Regulatory and Accreditation WFH opening. ... join an organization that invests in you as a Director Regulatory and Accreditation WFH? At HCA Healthcare, you...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- AdventHealth (Orlando, FL)
- …Maintain Advisory Board in compliance with CMS regulations . In collaboration with Medical Director , develop and implement policies and procedures related to ... area (DSA) which is designated by the Centers for Medicare and Medicaid Services (CMS). The area consists of...charges for organ and tissue acquisition fees. The Executive Director is responsible for reviewing , amending, and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Billing Director -Patient Financial Services- Corporate (ON SITE) Full-Time -Days** Responsible for direction and management responsibility over ... the business and operational activities of a department or medical care unit. **Qualifications** + 5 or more years of finance or administration building and… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Rush Health Contracting ... to disease management and complex care management. Our network includes Rush University Medical Center, Rush Oak Park Hospital, Rush Copley Medical Center,… more
- ChenMed (Richmond, VA)
- …Prepare and run referral team meeting- Create agenda for meeting. Gather info from Medical Director /Network Director /Referral Manager. + Prepare Referral ... Team Meeting Minutes and send minutes to Operation Director , Market Medical Director , Market...experience/understanding. + Understanding of cost as it relates to Medicare part A and B. EDUCATION / SPECIALIZED KNOWLEDGE… more
- Fresenius Medical Center (Kennesaw, GA)
- …accuracy. + Overseeing the monthly close process of the Advantx and Medical Manager sub-systems and providing the accounting department with cash deposits, projected ... Site locations of incorrect intake information and proper needed resolution. + Reviewing and monitoring routine follow-up activities of unpaid claims team for… more
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