- Molina Healthcare (Santa Fe, NM)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
- Highmark Health (Santa Fe, NM)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …education, and activation, ultimately improving patient access and adherence. The Director will work cross-functionally with medical affairs, market access, ... The Director , Consumer Marketing is responsible for leading the...deep expertise in direct-to-consumer (DTC) marketing, omnichannel engagement, and behavioral insights to create impactful and compliant consumer campaigns.… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and ... planning support for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an in-depth understanding of how… more
- CenterWell (Santa Fe, NM)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- Vighter Medical Group (Santa Fe, NM)
- …performing healthcare services under the medical direction of the National Medical Director and Physician Supervisors who collaborate with CBP's Office of ... in Texas, New Mexico, Arizona, California, and Florida. The medical staff must be capable of providing health...by the physician. + Performs history and physical assessment, behavioral health care, minor outpatient procedures, patient… more
- Molina Healthcare (Santa Fe, NM)
- …but not limited to, Hospitals, Independent Physician Association, and complex Behavioral Health arrangements. **Job Duties** This role negotiates contracts ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to… more