- Elevance Health (Chicago, IL)
- ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Molina Healthcare (Kenosha, WI)
- …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 (Kenosha, WI)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Kenosha, WI)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- R1 RCM (Chicago, IL)
- …enhancing the patient experience. As the Government Navigation Services (GNS) Business Development Director , you will focus on engaging and targeting new Tier 1 and ... in addition to prospecting and networking initiatives, the GNS Business Development Director will partner with the Business Development teams of in-house and… more
- Molina Healthcare (Kenosha, WI)
- …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
- Little City Foundation (Grayslake, IL)
- ASSISTANT DIRECTOR OF DAY SERVICES-GRAYSLAKE Job Details Job Location Grayslake - Grayslake, IL Position Type Full Time Education Level BA/BS Human Srvcs, 3yrs exp ... and Resume. Salary range: $ 50,000- 63,000/ year PURPOSE: The Assistant Director is responsible for providing leadership, direction, and operation oversight of… more
- Bayer (Chicago, IL)
- …minds to make a real difference, there's only one choice.** **Associate Director , Field Reimbursement, Oncology - Great Lakes Region** **Associate Director , ... HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working… more
- AbbVie (Mettawa, IL)
- …marketing or market access experience required. + Knowledge of the Commercial and Medicare FFS aspects of the Medical Benefit and associated utilization ... medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's… more
- AbbVie (Mettawa, IL)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... to join us. The individual hired as the Associate Director , Payer Contract Analytics - National Accounts, within the...+ Support all channels of payer contracting including Commercial, Medicare Part D, Medicaid and other Government channels +… more
- Walgreens (Deerfield, IL)
- …including disability/veterans". \#LI-TO1 **Job ID:** 1414700BR **Title:** National Director , Consultant Relations - Remote **Company Indicator:** Walgreens ... Systems, various other providers, etc), the various lines of business (Commerical, Medicare , Medicaid, etc) and the various healthcare services provided in the… more
- Molina Healthcare (Kenosha, WI)
- …ideally suited for candidates living in the Eastern Time Zone. Regional Director Quality Solutions (QS) is responsible for contributing to the strategic performance ... + Serves as the subject matter expert for all, Medicaid / Medicare / Marketplace quality, and data acquisition functions to ensure participants understands… more
- Humana (Chicago, IL)
- …be considered are Louisville, KY, Chicago, IL, and Nashville, TN._ As Director , Corporate Strategy, you will provide strategic guidance and thought leadership to ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Rush Health Contracting ... to disease management and complex care management. Our network includes Rush University Medical Center, Rush Oak Park Hospital, Rush Copley Medical Center,… more
- ChenMed (Chicago, IL)
- …and runs referral team meeting- Create agenda for meeting. Gather info from Medical Director /Network Director /Referral Manager. + Prepares Referral ... Team Meeting Minutes and send minutes to Operation Director , Market Medical Director , Market...experience/understanding + Understanding of cost as it relates to Medicare parts A, B and D + Proficient in… more
- Walgreens (Deerfield, IL)
- …pharmacy and payer segments. In addition, experience with billing procedures for hospital, medical offices and Medicare (B / D benefits). + Experience with ... with buy and bill practices, reimbursement and billing issues within oncology medical practices, particularly with Medicare . Should have experience with current… more
- Walgreens (Deerfield, IL)
- …pharmacy and payer segments. In addition, experience with billing procedures for hospital, medical offices and Medicare (B / D benefits). + Experience with ... complex reimbursement systems and flow of the healthcare dollar ( Medicare Part B/D, ACOs, ASOs, GPOs, Hospitals, etc.). **Job Responsibilities**… more
- All-Stat Portable (Skokie, IL)
- …Reimbursement management + Identify opportunities for insurance credentialing + Related to medical record request and CERTs + Work closely with All-Stat's Finance ... health information management issues and regulations + Comply with medical billing and coding policies and guidelines + Report...+ Report all department concerns and issues to the Director of Revenue for prompt necessary action. + Partner… more
- The Joint Commission (Oakbrook Terrace, IL)
- …appropriate judgment to seek assistance from others, including Central Office, the Field Director on call, the program specific Field Director , the Standards ... periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of-compliance reports. + Collaborate in a productive manner with… more
- Trinity Health (Maywood, IL)
- …suburbs. The three-hospital system includes Loyola University Medical Center (https://www.loyolamedicine.org/location/lumc) , Gottlieb Memorial Hospital ... coordinates the administrative aspects of a healthcare professional residency program ( medical , surgical, dental, podiatric) with special focus on becoming expert in… more