- Molina Healthcare (Layton, UT)
- …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
- Molina Healthcare (Layton, UT)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- Humana (Salt Lake City, UT)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live… more
- CenterWell (Salt Lake City, UT)
- …and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy ... community and help us put health first** The National Medical Director for Home-Based Care Programs is...medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary… more
- Evolent (Salt Lake City, UT)
- …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 (Salt Lake City, UT)
- …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 (Salt Lake City, UT)
- …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 (Salt Lake City, UT)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Baylor Scott & White Health (Salt Lake City, UT)
- … senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key ... **Job Summary** The Director , Denial Resource Center is responsible for the...improved utilization of appropriate patient care services. Collaborates with medical , clinical, HIM and other BSWH departments to ensure… more
- CVS Health (Salt Lake City, UT)
- …And we do it all with heart, each and every day. The Lead Director , National VBC Performance Planning & Insights will act as a strategic leader driving ... guide business decisions for national and local providers. The Director will also play a key role in supporting...efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas… more
- Humana (Salt Lake City, UT)
- …join our team as the Head of Talent Acquisition, for our CenterWell Senior Primary Care Organization (PCO). The PCO, including CenterWell and Conviva, delivers care ... to approximately 300,000 patients from many different Medicare Advantage health plans, and is the largest provider...Advantage health plans, and is the largest provider of senior -focused primary care in the country. Across these two… more
- WelbeHealth (Salt Lake City, UT)
- …senior care by providing an all-inclusive care option to our most vulnerable senior population. The Director , Federal Government Affairs will lead a bold ... regulatory affairs function with Congress and the Centers for Medicare and Medicaid Services (CMS) + Develop and implement...uniquely cared for. + 401k + employer match + Medical insurance coverage ( Medical , Dental, Vision) starting… more
- Molina Healthcare (Layton, UT)
- …activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Humana (Salt Lake City, UT)
- …to deliver agile, data-driven, and personalized member experiences at scale. As Director of Marketing Communication Operations, you will play a pivotal leadership ... the AVP of Marketing Operations, you will shape strategic direction, influence senior stakeholders, and lead a high-performing team of marketers. You'll drive… more
- Danaher Corporation (Salt Lake City, UT)
- …commercial customer engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value ... Danaher Business System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a… more
- Humana (Salt Lake City, UT)
- …+ Cultivate effective partnerships in a matrix environment of coding educators, medical director , clinical and market operations. + Facilitate, track and ... caring community and help us put health first** The Senior Coding Educator will work closely with providers to...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Cardinal Health (Salt Lake City, UT)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- CVS Health (Salt Lake City, UT)
- …current skills and development needs. Assesses training needs and works with SIU Director on development plans for team members. Develops and maintains close working ... Coordinates and collaborates with program integrity staff, compliance, and senior leadership. Contributes to the development and delivery of educational… more