- Humana (Dover, DE)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- BlueCross BlueShield of North Carolina (NC)
- …Description** Provides leadership and oversight for development, implementation, and execution for Payment Integrity (PI) programs focused on payment ... affordability. Acts a liaison for all reimbursement policies and payment integrity initiatives to communicate cost of...flexibility, and the autonomy to do great work + Medical , dental, and vision coverage along with numerous health… more
- CVS Health (Providence, RI)
- …approximately 6 employees and overall scope of 25-30 to develop enterprise-wide solutions ( medical cost containment and payment integrity ) to address ... industry experience in product, finance, operations, network/out of network, payment integrity , and/or related disciplines + Proven leadership/management… more
- Marriott (Bethesda, MD)
- …Y **Position Type** Management This is a temporary position. As a member of the Payment and Fraud Products team, the Director 's primary focus is Fraud related ... initiatives and support for property and above property payment capabilities. This will involve integration with many teams across the organization and understanding… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to the Associate Director of Professional Reimbursement Strategy, the Payment Integrity Reimbursement Policy Quality Assurance (QA) Analyst is responsible ... for completing invoice and reconciliation claim audits for BCBSMA's payment integrity programs. Quality assurance audit reviews and core functions include… more
- Tufts Medicine (Burlington, MA)
- …Overview** The position is responsible for CDI program strategy and oversight. The Director will partner with the Senior Director , Clinical Revenue Cycle to ... (UM), Case Management, Quality and Physician advisors and leaders. The Director oversees the manager and clinical documentation specialists (CDSs) in planning,… more
- Northwell Health (Westbury, NY)
- **Req Number** 158136 Job Description The Director , Corporate Finance (RIO) promotes the financial viability of Northwell Health by effectively managing the ... organization's revenue capture operations. The Director works in close partnership with many aspects of the organization and is central to creating a comprehensive… more
- Intermountain Health (Broomfield, CO)
- **Job Description:** The Senior Medical Director for the Musculosketal Service Line serves as the physician leader for Peaks Region physicians and advanced ... professionals (APs). The Senior Medical Director works collaboratively in a dyad...leader for our model healthcare system as evidenced by integrity , passion, and energy; being a champion of Intermountain's… more
- State of Colorado (Denver, CO)
- …Medicare fraud, waste, and abuse (FWA) operations that includes work on: + Program Integrity + Provider Payment Reviews + Fraud Investigation + Waste and abuse ... Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4941547) Apply Fraud Waste and...ten (10) years that includes work on: + Program Integrity + Provider Payment Reviews + Fraud… more
- CVS Health (Sacramento, CA)
- …to safeguard healthcare integrity and protect patient well-being. As the Medical Director of Healthcare Fraud Investigations, you'll lead our efforts to ... do it all with heart, each and every day. Medical Director - SIU (Special Investigations Unit)... will be responsible for making both pre and post- payment claim payment determinations based on Aetna… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... and medical criteria. + Assists with training medical director colleagues and nursing staff ,...changes in healthcare. + Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and… more
- American Express (New York, NY)
- …the world's best customer experience every day. And we'll do it with the utmost integrity , and in an environment where everyone is seen, heard and feels like they ... together into a center of excellence to drive operational excellence for payment execution, enable innovative payment products, services, and capabilities to… more
- American Express (New York, NY)
- …the world's best customer experience every day. And we'll do it with the utmost integrity , and in an environment where everyone is seen, heard and feels like they ... together into a center of excellence to drive operational excellence for payment execution, enable innovative payment products, services, and capabilities to… more
- Mastercard (O'Fallon, MO)
- …people, businesses and governments realize their greatest potential._ **Title and Summary** Director of Network Relations & Compliance Overview: The Director of ... Network Relations & Compliance will manage multiple Payment Networks, utilizing deep industry knowledge of both Domestic US and International Payment Networks.… more
- HCA Healthcare (San Antonio, TX)
- …include scheduling, registration, insurance verification, hospital billing, revenue integrity , collections, payment compliance, credentialing, health information ... Do you have the career opportunities as an Assistant Director of Clinical Data Abstraction you want with your...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- State of Minnesota (St. Paul, MN)
- …in coordination with internal and external partners. + Monitor and improve payment workflows to ensure alignment with financial integrity standards. + ... **Working Title: Payments Supervisor** **Job Class: State Program Administrator, Director ** **Agency: Department of Employment and Economic Development** + **Job… more
- Mastercard (New York, NY)
- …governments realize their greatest potential._ **Title and Summary** Product Director , Mastercard Transaction Services - Digital/Crypto focus Overview Mastercard ... operate in compliance with multiple global regulatory frameworks, and monetize payment flows not currently addressable by Mastercard. The MTS Product enablement… more
- Mastercard (Harrison, NY)
- …their greatest potential._ **Title and Summary** Digital Currency Enablement Director MTS Overview: Mastercard Transaction Services (MTS) and its subsidiaries ... the legal entities under which all of Mastercard's licensed money transfer and payment initiation services will be conducted, reporting into the Commercial and New… more
- San Francisco Foundation (San Francisco, CA)
- Director of Grants Administration Location: San Francisco, CA Department: Operations-Grants Administration Type: Regular, Full-Time, Exempt Min. Experience: ... of outcome goals of role and foundation. Position Summary: The Director of Grants Administration (DGA) position collaborates, develops, and implements strategic… more
- HCA Healthcare (Rochester, NH)
- …include scheduling, registration, insurance verification, hospital billing, revenue integrity , collections, payment compliance, credentialing, health information ... are committed to caring for patients with purpose and integrity . We care like family! Jump-start your career as...like family! Jump-start your career as an HIM Assistant Director today with Frisbie Regional Hospital. **Benefits** Frisbie Regional… more