- AmeriHealth Caritas (Newark, DE)
- ** Medical Director , LTSS ** Location: Newark, DE Primary Job Function: Medical Management ID**: 34195 **Job Brief** Qualified candidates must reside in ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical Directors, Utilization Management and… more
- CVS Health (Hartford, CT)
- …make health care more personal, convenient and affordable. Job Purpose and Summary: The LTSS /SAI National Senior Medical Director , reporting to a Regional ... closely with data analytics team and develops specific actions to manage LTSS related medical cost trends* Develops benchmarks for LTSS clinical staff… more
- Centene Corporation (Harrisburg, PA)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve… more
- Humana (Richmond, VA)
- …is seeking a Director , Care Management of Long-Term Services and Supports ( LTSS ) who will lead teams of nurses and behavior health professionals responsible for ... care management. The Director , Care Management ( LTSS ) requires an in-depth...for the planning, directing, and successful management of the LTSS Clinical Strategy for Department of Medical … more
- Humana (Charleston, WV)
- …put health first** Humana Healthy Horizons in Virginia is seeking an Associate Director , Care Management ( LTSS /ABD) who will lead teams of healthcare ... in providing integrated services for the clinical teams. The Associate Director , Care Management requires a solid understanding of how organization capabilities… more
- Humana (Annapolis, MD)
- …first** Humana Healthy Horizons in Virginia is seeking a Manager, Care Management ( LTSS -ABD) who will lead a team of nurses and behavior health professionals ... Aged, Blind and Disabled (ABD), those enrolled in Long-Term Services and Supports ( LTSS ) Waiver Services, in hospice and/or in nursing facilities. They will lead … more
- CVS Health (Tallahassee, FL)
- …business strategies are delivered and financial, compliance and quality objectives are met. The LTSS Director will partner closely with the LTSS Executive ... and affordable. Position Summary The Long-Term Services and Support ( LTSS ) Director will partner closely with the...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director (Staff Geriatrician or Physician with Ten (10) Years...resource for the duals and long-term services and support ( LTSS ) program as well as its providers with a… more
- State of Massachusetts (Boston, MA)
- …Agency (HHA), Independent Nursing (IN), Therapies, DMEPOS programs (Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment, Prosthetics and Orthotics), ... Program of All Inclusive Care for the Elderly (PACE). The Deputy Director Personal Care Attendant Program, Fiscal Intermediary Operations manages the contract for… more
- Liberty Healthcare Corporation (Fayetteville, TN)
- …growth, Liberty Healthcare seeks qualified candidates for a potential new part-time Medical Director position. This is a virtual administrative role which ... a flexible schedule and 20-hour workweek. As Liberty Healthcare's Medical Director , you will serve as an...eligibility assessment and appeals for Long-Term Services and Supports ( LTSS ) + Supports Intensity Scale (SIS) and Inventory for… more
- CVS Health (Hartford, CT)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... physical, behavioral and socioeconomic needs.* Partner closely with the Executive Director of Duals and other Duals Care Management leadership to collaborate… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... person as needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
- Baystate Health (Springfield, MA)
- …and other outside entities to align strategies and tactics. Along with the Director of Quality and Medical Management, he/she operationalizes programs aligned ... direction of and in partnership with the Chief of Clinical Integration, the Director of Population Health & Clinical integration is accountable for the strategic and… more
- Liberty Healthcare Corporation (Fayetteville, TN)
- …growth, Liberty Healthcare seeks qualified candidates for a potential new Quality Director position. This is a key leadership role with a statewide program ... technical assistance + Pre-Admission Screening and Resident Review (PASRR) processes + Medical or Level of Care (LOC) eligibility assessment and appeals for… more
- Liberty Healthcare Corporation (Fayetteville, TN)
- …growth, Liberty Healthcare seeks qualified candidates for a potential new Clinical Director position. This is a key leadership role with a statewide program ... technical assistance + Pre-Admission Screening and Resident Review (PASRR) processes + Medical or Level of Care (LOC) eligibility assessment and appeals for… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** The Director , Quality & Control Assurance reports to the VP of Quality & Control Assurance is responsible ... Medicare Risk Adjustment, HCC, clinical and coding reviews; DRG and medical records reviews; technology/systems and coding upgrade and implementation reviews (eg… more
- Humana (Bedford, IN)
- …+ Assisting members in maintaining Medicaid eligibility + Collaborate with Medical Director /Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, ... include: + Administer initial and ongoing long-term services and support ( LTSS ) related assessments through person-centered thinking approaches. + Contacts members… more
- Greater Lynn Senior Services (Lynn, MA)
- …scheduled hours of work you may be eligible for: + Hybrid work schedule + Medical and Dental insurance + Health Spending Account + Flexible Spending Accounts (FSA) - ... referral bonuses of up to $1,000 Position Overview: The LTSS Program Clinical Care Nurse will complete program Comprehensive...The NRLP Clinical Care Nurse will support the Program Director in day to day operations of the program.… more
- Elevance Health (Columbus, OH)
- … management, medical staffing, seasonality issues, detailed communications with the medical director , and nurse leader. Collaborate with HSO and Carelon on ... Ensure county expansion is in alignment with Medicaid growth goals and LTSS strategies. + Oversee Alliance contract requirements and performance, growth strategies,… more
- Centene Corporation (Dover, DE)
- …of plan specific literature and education materials in conjunction with medical director and corporate oversight. **Education/Experience:** Bachelor's or ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more