- Molina Healthcare (Rio Rancho, NM)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Molina Healthcare (Rio Rancho, NM)
- …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...and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies… more
- Molina Healthcare (Rio Rancho, NM)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and procedures to improve… more
- Molina Healthcare (Rio Rancho, NM)
- 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 (Rio Rancho, NM)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight of ... supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of training for all… more
- Molina Healthcare (Rio Rancho, NM)
- …reserves for appropriateness monthly + Work collaboratively with Actuarial and Medical Economics partners to evaluate correlation among various parameters impacting ... IBNR, including bed days and admits per 1,000, prescription drug utilization, billed dollars of inventory, and other measurable factors that may be leading indicators of the level of reserve required for a particular cell (eg, a particular product within a… more
- CDM Smith (Rio Rancho, NM)
- …Packages and defining Scopes of Work under the supervision of the Director of Construction/President or Project Manager. * Responsible for overseeing total ... reports, etc.), purchase requisitions, change request, etc., under supervision of Director of Construction/President or Project Manager. * Ensures all field… more
- Yearout Mechanical LLC (Rio Rancho, NM)
- …among its clients. **Benefits Overview** **Health & Welfare:** Company Paid medical , dental, vision, prescription drug, accident & sickness benefit, basic group ... without a prior signed agreement authorized by Legence Holdings LLC's CHRO or Director of Talent Acquisition will not incur fees and are considered property of… more
- Jacobs (Rio Rancho, NM)
- …and communicating necessary corrective actions to the necessary personnel (ie, client, director , manager, regulatory agencies) * Ability to work with the client's ... national origin, ancestry, sex (including pregnancy, childbirth, breastfeeding, or medical conditions related to pregnancy, childbirth, or breastfeeding), age, … more
- Molina Healthcare (Rio Rancho, NM)
- …issue escalations and Joint Operating Committees on exception. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC ... contracting. * Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. * Supports VBC network throughout the state to include onboarding VBC providers and supporting… more
- Molina Healthcare (Rio Rancho, NM)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, and local health plan resources. + Responsible ... metrics such as HEDIS and STARS, knowledge of coding + Knowledge of medical economics and financial reporting. Must be able to walk stakeholders (internal and… more
- Genesis Healthcare (Rio Rancho, NM)
- …Powerback is the place for you. **Why Powerback?** + **Benefits** : We offer Medical , Dental, and Vision plans to Full-Time team members. We offer Dental and Vision ... Therapy Assistant **Location/work environment:** In facility **Reporting structure:** Reporting to Director of Rehab As an Occupational Therapy Assistant, you help… more