- Molina Healthcare (Savannah, GA)
- …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 (Savannah, GA)
- …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 (Savannah, GA)
- **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 (Savannah, GA)
- …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
- Molina Healthcare (Savannah, GA)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Molina Healthcare (Savannah, GA)
- …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
- Genesis Healthcare (Savannah, GA)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... program. Responsibilities The Senior Therapist is responsible for assisting the Director of Rehab in the efficient Clinical management of rehabilitation services… more
- CenterWell (Savannah, GA)
- … 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
- CenterWell (Bluffton, SC)
- …caring community and help us put health first** Reports To: Associate Director , Home Health Branch Administrator FLSA: Exempt **Work Schedule** : Full-time/40 Hours ... final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers… more
- Gentiva (Savannah, GA)
- …Care Manager** to join our team.You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible for ... referrals/inquiries in a timely, professional, and compassionate manner, including triage of medical concerns within scope of practice. + Preparing for, serving on,… more