- CHRISTUS Health (Santa Fe, NM)
- …and Alternative Payment Models and quality deliverables working in conjunction with Medical Director of Ambulatory Quality. * Supervision and support of ... of care coordination and population health programs. In conjunction with director will oversee planning, budget, and implementation of care coordination programs… more
- CHRISTUS Health (Santa Fe, NM)
- …high standard of nursing care. Under the primary supervision of the Palliative Care Medical Director or Provider, will develop skills in and share responsibility ... support, in collaboration with Case Management, when patients are referred to hospice. Medicare rules and regulations pertaining to hospice care at home, GIP hospice… more
- CHRISTUS Health (Alamogordo, NM)
- …automated InterQual(R) preferred. Knowledge of the regulatory environment, including Medicare Conditions of Participation, DNV standards, HIPAA, and reporting ... requirements. Submits appeals in a timely manner, upon request by the Director . Initiates discharge planning on assigned patients within 24 hours of admission.… more
- CVS Health (Hartford, CT)
- …based (work at home) based anywhere in the US.**Responsibilities of this Medical Director role are related to Medicare Appeals.* Direct daily work on part C ... encumbrances* Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience.*… more
- Elevance Health (Richmond, VA)
- …office locations Work schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and implementing ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...clinical programs with specific medical condition focus for all lines of business enterprise… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health episodic and per diem requests. The Medical Director provides medical interpretation... Medicare population and reports to the Lead Medical Director . Other duties: + Identify … more
- CVS Health (Hartford, CT)
- …Enterprise Economics, the Strategy team supporting Medicare , as well as the core Medicare Finance team. This Executive Director will also: + Be a strategic ... affordable. Position Summary As a direct of the CFO, Medicare this role will work to ensure that the...Enterprise Economics, Clinical, Network, Related Parties (Shared Services) and Medical Economics to execute on growth priorities. + Partner… 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 ... BCBSMA's purposeful re-entry into the Group Medicare Advantage Market. The role will have responsibility for Group Medicare Advantage and Medicare … more
- CVS Health (New York, NY)
- …for energetic team member to bring discipline and strategic thinking to our Medicare Marketing Efforts. The Lead Director , Medicare Marketing Strategic ... critical role in enabling, optimizing and advancing the Aetna's Medicare Marketing. This role will serve as a key...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Hartford, CT)
- …convenient and affordable. Position Summary Works closely with the Executive Director , National SNP Sales Strategy, in the creation, refinement and delivery ... a well-rounded SNP subject-matter-expert in sales, distribution, marketing and Medicaid/ Medicare processes, contributing holistic support to any recommendation. +… more
- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and ... the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional… more
- CVS Health (Hartford, CT)
- …Stars, and Revenue Integrity teams for each of the 4-5 regions that Medicare operates under. This organization will help strengthen the teams that currently support ... important part in helping to align and communicate the Medicare Local Market teams around current performance, and the...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- UCLA Health (Los Angeles, CA)
- … Director of Pharmacy Benefits Management! Reporting directly to the Chief Medical Officer of Medicare Advantage, you'll spearhead the development and ... desired + Two or more years of experience in Medicare programs, preferred + Degree from an accredited school...throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David… more
- The Cigna Group (Morris Plains, NJ)
- The Director , Centene Account Management provides strategic, financial, clinical, relationship, and organizational leadership for the Medicare D and Exchange ... experience within the PBM or healthcare industry preferred; Experience in Medicare /Medicaid/Exchange market highly preferred. + Experience managing large books of… more
- CVS Health (Hartford, CT)
- …strategic leadership and oversight for financial planning and analysis for a Medicare Local Market by managing a team of financial analysts, coordinating budgeting ... budget presentations for senior leadership, and day-to-day ad-hoc analyses + Medicare Experience. EducationBachelor or similar work experience This is a hybrid… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As an important member of our Medicare Advantage team, you will provide strategic oversight and leadership for our Member and ... locations throughout metro Los Angeles. We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of… more
- AdventHealth (Altamonte Springs, FL)
- …and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital ... Reimbursement Analyst is responsible for preparing and filing the annual Medicare , Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal… more
- The Cigna Group (Bloomfield, CT)
- …- United States** **Summary** The Business Analytics Senior Advisor position within the Medicare Growth Analytics Team is an opportunity to provide leadership on our ... analytics strategy, to support our broader Medicare Growth team and provide actionable insights and analytics....to achieving its goals. Reporting to the Growth Analytics Director , this position will coordinate with cross functional teams… more
- CVS Health (Santa Ana, CA)
- …business. CVS Health/Aetna is working to transform the way California Medicare beneficiaries experience health care - improving quality, emphasizing whole-person ... Manager to support the growth of our industry leading Medicare business. This is a highly collaborative role in...the United States and will report to the Sales Director for Southern California. This is a career position… more
- UCLA Health (Los Angeles, CA)
- …Actuary, Director of Compliance, Director of Managed Care and Director of Medicare Advantage Operations regarding accounting for risk contracts. Provide ... and maintaining accounting and finance functions for the newly formed Medicare Advantage health plan. Key Responsibilities include: + Leading, developing, and… more
