- CVS Health (Richmond, VA)
- …the Aetna Virginia Medicaid plan and the UM team. The UM Medical Director will ensure timely and consistent responses to members and providers related to ... and every day. **Position Summary:** Ready to take your Medical Director skills to the next level...opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, Florida,… more
- CVS Health (Baton Rouge, LA)
- …Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia . This Medical Director will be a "Work from Home" ... do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout… more
- CVS Health (Springfield, IL)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California,...Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from… more
- Integra Partners (Troy, MI)
- Position Summary + Integra Partners is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a salaried, ... Job Responsibilities: + Conducting timely clinical review of Durable Medical Equipment (DME) requests in alignment with Medicare/ Medicaid...Management Nurse will route the case to the UR Medical Director . The UR Medical … more
- State of Colorado (Denver, CO)
- …and across the Colorado Medicaid Enterprise ecosystem which includes 16 medicaid modules, processing medical claims and encounters, member eligibility, ... Federal regulatory policy and audits of the systems, and Medicaid claims reimbursement, provider enrollment and medical ...and reports successes and issues to the ESI Division Director . This position analyzes and communicates complex State and… more
- State of Colorado (Denver, CO)
- …as a policy Subject Matter Expert (SME) for the MAGI (Family and Children's Medicaid and CHP+) Medical Programs. Typical duties include, but are not limited ... UHA04385_06.2025 Department Department of Health Care Policy and Financing Division Medicaid Operations Office Opening Date 06/24/2025 Closing Date 7/2/2025 11:59 PM… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …hospital revenue cycle risk areas highlighted by the OIG, Medicare, State Medicaid , State Insurance Fraud; Managed Care or Governmental Value-Based payment programs ... risk areas + Assists in auditing and investigations requested by the System Director , Compliance. + Assists in the development of compliance corrective action plans… more
- Bon Secours Mercy Health (Richmond, VA)
- …the effective management of the non-clinical support service functions including medical records, patient documentation data entry, department payroll and office ... Health System. **KEY RELATIONSHIPS:** + Works closely with the Administrative Director (s) to develop and implement operational & clinical workflows. + Collaborates… more
- State of Colorado (Denver, CO)
- …Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health ... Defined Contribution Plan, plus 401K and 457 plans + Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/ medical -benefits) , Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental-insurance) , and… more
- Service Source (Lorton, VA)
- …active engagement, recreation, and vocational training, as well as a variety of medical and behavioral supports at all levels of intensity. ServiceSource has been ... career pathways ({Program Manager >> Sr. Program Manager/ Division Manager >> Director )) + Tuition reimbursement and professional development funds available. + $500… more
- Goodwin Living (Bailey's Crossroads, VA)
- …annually recognized as one of the top 100 employers for interns by the Top Virginia Employers for Intern Awards. These honors are based entirely on feedback from our ... social and emotional needs which may be related to medical conditions. The position will also provide back up...meeting and other meetings at the direction of the Director of Social Work. + Coordinates services and referrals… more
- State of Colorado (Denver, CO)
- …Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health ... Defined Contribution Plan, plus 401K and 457 plans + Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/ medical -benefits) , Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental-insurance) , and… more
- State of Colorado (Denver, CO)
- …plus 401K and 457 plans + Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/ medical -benefits) , Dental ... Spending Accounts (https://dhr.colorado.gov/state-employees/state-employee-benefits/flexible-spending-accounts) (FSAs) + Family Medical Leave Act (FMLA) (https://dhr.colorado.gov/state-employees/time-off-leave/family- medical… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …position will be assigned to the Department's office located in Fairfax Virginia . The Quality Control (QC) manager oversees two Quality Control units, Centralized ... control documents and write corrective action plans/agency responses for the Division Director . The QC manager works with the Quality Triad on identified performance… more
- University of Virginia (Charlottesville, VA)
- …PB Coding education team supporting physicians, other healthcare providers, and medical coders employed by UVA Health on coding practices, documentation guidelines, ... support the overall operational goals of the department and institution. + Assist Director with development of annual budget. + Design, develop and execute standard… more