- Molina Healthcare (Louisville, KY)
- **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 (Louisville, KY)
- …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 (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Evolent (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Frankfort, KY)
- … 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
- Humana (Louisville, KY)
- …part of our caring community and help us put health first** The Associate Director will report directly into the Associate Vice President of Procure to Pay ... while considering risk tolerance and associate impact + Regularly communicate with senior leadership team regarding policy and audit findings + Responsible for the… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Senior Learning Design Professional partners with IT leaders and associates to identify and address ... consulting, adult learning theory, and instructional design best practices, the Senior Learning Design Professional develops content collaborates with subject matter… more
- Humana (Frankfort, KY)
- …language models (LLMs), artificial intelligence, and other relevant topics. The Senior Penetration Tester enables secure and compliant business operations by ... the enterprise's offensive security program by collaborating with the Associate Director , Penetration Testing. **Mission & Impact** + Conduct comprehensive security… more
- Humana (Frankfort, KY)
- …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... company's total revenue and earnings. Team members partner with senior leaders of the business unit, and more broadly...initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the… more
- CVS Health (Frankfort, KY)
- …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
- Waystar (Louisville, KY)
- …and drive outbound prospecting to generate new business + Must call into senior management at large healthcare organizations as part of lead development and ... qualification. Eg CTO, CIO, VP of Revenue Cycle, and Director level contacts + Conduct research on accounts using...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more