- Molina Healthcare (Fort Worth, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (Fort Worth, TX)
- …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 (Fort Worth, TX)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- Molina Healthcare (Fort Worth, TX)
- **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
- Molina Healthcare (Fort Worth, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (Fort Worth, TX)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- CenterWell (Fort Worth, TX)
- …a part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- Molina Healthcare (Fort Worth, TX)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- Texas Health Resources (Denton, TX)
- Director Nursing Perioperative _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like ... more than 1,100 employees, and 450 physicians on our medical staff, we're one of the largest employers in...months of hire Skills Knowledge of industry standards JCAHO, Medicare , OSHA, Regulatory standards for affected area of responsibility.… more
- USAA (Plano, TX)
- …makes us special and impactful. **The Opportunity** USAA is seeking a talented ** Director , Retirement Income** to lead multiple teams of Health, Life or Retirement ... with Legal, Risk and Compliance on interpretation of CMS (Center for Medicare and Medicaid Services) rules to provide guidance and clarification to executive… more
- Molina Healthcare (Fort Worth, TX)
- …and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and ... recontracting initiatives. Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads preparation… more
- Texas Health Resources (Plano, TX)
- …. Experience in Graduate Medical Education Preferred and . Previous CMO, ACMO or medical director experience Preferred . MD - Medical Doctor Texas ... the Hospital. 2. Provide oversight and leadership to the director of Medical Staff Office and the...required upon hire . Knowledge of industry standards JCAHO, Medicare , OSHA, Organizational management, regulatory standards for affected area… more
- CenterWell (Fort Worth, TX)
- …of medical expertise with the care team through daily huddles. Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- Elevance Health (Coppell, TX)
- …company policy and procedures. + Completes admission process as directed by Center Director . + Performs physical assessment on each patient as warranted and for new ... diagnosis. + Documents all pertinent data in the patient's medical record. + Reports all significant changes or observations...Reports all significant changes or observations to the Center Director and is responsible for the follow up on… more
- CVS Health (Dallas, TX)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... is going to be a late shift for the Medicare CMAs working until at least 7pm in their...Management Associate you will be supporting comprehensive coordination of medical services including Care Team intake, screening and supporting… more
- HCA Healthcare (Irving, TX)
- …want with your current employer? We have an exciting opportunity for you to join Medical City Healthcare at Home which is part of the nation's leading provider of ... healthcare services, HCA Healthcare. **Benefits** Medical City Healthcare at Home, offers a total rewards...involved in patient care activities. In conjunction with the Director of Clinical Services, is responsible for development of… more
- Elara Caring (Fort Worth, TX)
- …and continuing education opportunities for all employees + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer match + Paid ... year in the home care industry + Knowledge of Medicare /Medicaid home care benefits, policies, and procedures + Valid...to perform job tasks You will report to the Director Nursing or Clinical Administrator. _This is not a… more
- Molina Healthcare (Fort Worth, TX)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, and local health plan resources. + Responsible ... program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment, specifically with… more