- Seattle Children's (Seattle, WA)
- …Seattle Children's and University of Washington Department of Fetal Surgery leadership, Medical Director MFM and OB Services, Perioperative Services, Nursing to ... growth and support the mission of Seattle Children's Hospital. The perinatal director is responsible for the day-to-day clinical nursing functions of the Special… more
- Molina Healthcare (Tacoma, WA)
- …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 (Tacoma, WA)
- …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 (Tacoma, WA)
- 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 (Tacoma, WA)
- **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 (Seattle, WA)
- …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 ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Molina Healthcare (Tacoma, WA)
- …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 (Tacoma, WA)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Molina Healthcare (Tacoma, WA)
- …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
- Elevance Health (Seattle, WA)
- **Clinical Pharmacy Account Director - Clinical Account Management** **Location:** This role requires associates to be in-office 3 days per week, fostering ... is granted as required by law. The **Clinical Pharmacy Account Director ** is responsible for building client relationships. This role includes responding… more
- Molina Healthcare (Tacoma, WA)
- …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
- Aveanna Healthcare (Lakewood, WA)
- …Details Aveanna Healthcare is growing and in need of an experienced Executive Director for our Tacoma, WA location. Position OverviewThe Executive Director ... time with or without notice. Vaccination RequirementsAs an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- CenterWell (Kent, WA)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Sea Mar Community Health Centers (Federal Way, WA)
- …to pay for services. Sea Mar's network of services includes more than 90 medical , dental, and behavioral health clinics and a wide variety of nutritional, social, ... and timely processing of all third party insurance, Medicaid, Medicare , Private Pay, and special programs. This position will...with ICD-10, CPT and CDT coding, both dental and medical terminology preferred. + Applicant must be proficient in… more
- Danaher Corporation (Seattle, WA)
- …engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value and Access team. ... + Communicate regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through internal meetings, payer research, and… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …teaching the Care Coordination Department; serving as a member of the medical staff; and coordinating with Hospital leadership on matters regarding progression of ... patient care, medical necessity, compliance with regulatory guidelines, payer relationships; clinical...Assist with the segmentation of concurrent review offerings into Medicare / Medicaid / Commercial Payors, as needed *… more
- Sea Mar Community Health Centers (Seattle, WA)
- …to pay for services. Sea Mar's network of services includes more than 90 medical , dental, and behavioral health clinics and a wide variety of nutritional, social, ... in meetings of professional groups to maintain communications with the medical /home care community. Essential Duties and Responsibilities: + Planning: + Develop… more
- University of Washington (Seattle, WA)
- …variety of sources including institutional funding, clinical revenues, gifts, graduate medical education (GME) salary, and grants and contracts. The administrator ... Manage GME finances supporting the residency program, including tracking for Medicare reporting and contractual allocations. + Oversee staff whose responsibilities… more
- Molina Healthcare (Tacoma, WA)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, and local health plan resources. + Responsible ... program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment, specifically with… more
