- Marion County, OR (Salem, OR)
- …Works under the general supervision of the Health Clinical Supervisor 2 or Medical Director , who assigns duties, establishes goals and reviews results. ... to apply. GENERAL STATEMENT OF DUTIES Behavioral Health Nurse Senior is responsible for coordination of nursing services for... medical needs of clients and report to Medical Director . Assist in referrals to community.… more
- Molina Healthcare (Vancouver, WA)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- CareOregon (Portland, OR)
- … coverage and physician/leader back up is available at all times. + Works with Senior Medical Director to ensure physician availability and oversight at all ... and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to...and must comply with all federal laws. Job Title Medical Director , NP - Primary Care Requisition… more
- Humana (Salem, OR)
- …lead Medical Directors performing utilization management for inpatient authorizations training medical director team to assist and facilitate new hires and ... remediation of medical directors performing Medicare utilization management processes...rate with denials and overturns. Deliver the upmost consistent medical director decision making. + _Internal Operations… more
- Evolent (Salem, OR)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Salem, OR)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Salem, OR)
- …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Salem, OR)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Salem, OR)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... with cross-functional teams, including **clinical reviewers, product, management, and senior leadership,** to improve decision-making and care outcomes. + Assist… more
- Humana (Salem, OR)
- …We are seeking an experienced and strategic leader to fill the position of Director of Internal Pharmacy Forecasting and Performance Analytics. This role will lead a ... of five direct reports and 1-2 indirect reports. The Director will play a key role in driving business...leader will need deep understanding of the complexities of Medicare Part D benefit design and regulatory changes to… more
- Humana (Salem, OR)
- …of our caring community and help us put health first** The Director , Actuarial Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
- CenterWell (Salem, OR)
- …MSSP, and future models. Under general direction and supervision from the ACO Director , the Senior Strategy Advancement Professional will bring a combination of ... an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health, Accountable Care Organizations (ACOs), medical … more
- Humana (Salem, OR)
- …community and help us put health first** We are seeking a highly skilled Director , Program Management to oversee the development and execution of a new eCommerce ... managing complex projects independently, ensuring alignment with strategic objectives. The Director will play a key role in establishing the structure, frameworks,… more
- CenterWell (Salem, OR)
- …Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner ... of management experience + 8 or more years of Medical Coding, IPA, or similar experience + Medical...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- CenterWell (Vancouver, WA)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Evolent (Salem, OR)
- …ongoing surveillance of coding updates from authoritative sources, including the American Medical Association (AMA), Centers for Medicare & Medicaid Services ... Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Senior Scope Analyst, Scope Management** The Specialty Scope Management team is made up… more
