- Elevance Health (Atlanta, GA)
- ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will **must live** within 50 miles of one ... of our Elevance Health PulsePoint locations. The ** Medicare Medical Director ** is responsible for the administration of physical and/or behavioral health medical… more
- Elevance Health (Columbus, OH)
- ** Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... within 50 miles of our Elevance Health PulsePoint locations. The ** Director of Medicare Risk Adjustment Analytics and Reporting** is responsible for planning,… more
- ActiveProspect, Inc. (Austin, TX)
- …for customer acquisition. Job Summary ActiveProspect is seeking a Sales Director for our Medicare /Health Insurance vertical. ActiveProspect currently works ... growth in the vertical with a high-energy, passionate sales director . Your role will be to expand our footprint...expand our footprint in this category. As a Sales Director , you will be responsible for all aspects of… more
- CVS Health (Salem, OR)
- …remote based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on ... providers). * Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation in the Second Look… more
- Humana (Columbus, OH)
- …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation ... community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests...an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).… more
- Point32Health (Canton, MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director is responsible for the overall success of Point32Health's Medicare ... offerings, including the Medicare Advantage and Medicare Supplement product lines. In addition to managing existing...In addition to managing existing products and markets, the Director will lead or play a key role in… more
- Elevance Health (Columbus, OH)
- …deliver member-centered, lasting pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director ... preserving and deepening relationships with clients which include Elevance Health Medicare Health Plans. This position, structured around geographic regions and… more
- Molina Healthcare (NY)
- …regulatory requirements. **Job Duties** + Under the leadership of the VP Medicare Segment Lead, this role will facilitate transparent and compliant execution of ... Medicare performance objectives. + Coordinates accountabilities between segment and...mitigate risk and develop/implement improvements across areas that impact Medicare performance. + Collaborates across Medicare segment,… more
- Molina Healthcare (Long Beach, CA)
- …improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare , ... relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience demonstrating… more
- Healthfirst (NY)
- **Duties & Responsibilities:** + Develops, refines, and executes Medicare telesales strategy, including partnership with Dial America and across the various sales ... areas (eg, Analytics, Development, etc.) and stakeholders within the Medicare Sales team to define and implement enhancements to...VP in the development and management of the annual Medicare tele sales operating budget + Partners with Legal,… more
- UCLA Health (Los Angeles, CA)
- …of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is instrumental in participating in the planning with the ... director and other functional areas for implementation and execution...and the manager of coding and education. The Assistant Director of Risk Adjustment will oversee the manager of… more
- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements: The physical requirements described ... Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY...they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and … more
- CVS Health (Sacramento, CA)
- … Director UM decisions. If specifically assigned to one business segment (ie, Medicare clients), each director will become sufficiently skilled in various UM ... UM decisions. If specifically assigned to one business segment (ie, Medicare clients), each director will become sufficiently skilled in various UM programs to… more
- AmeriHealth Caritas (Newtown Square, PA)
- **Corporate Director , Population Health Clinical Operations, Medicare ** Location: Newtown Square, PA Primary Job Function: Medical Management ID**: 37990 **Job ... Medicare Care Management and the Chief Medical Officer, the Corporate Director , Population Health Medicare Clinical Operations is responsible for multiple… more
- Centene Corporation (Austin, TX)
- …federal and state legal and regulatory requirements as it relates to Medicare compliance and HPMS/CMS regulations. + Oversee and monitor various of cross-functional ... CMS ensure timely completion of CMS requirements and expectations. + Ensure all Medicare and Medicaid product and services are being tested for compliance with… more
- Molina Healthcare (NY)
- …**Job Summary** Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. ... Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member relationships. Recommends and implements programs to support member needs… more
- CVS Health (Hartford, CT)
- …pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise ... Health company has an outstanding opportunity for a Medical Director . Ready to take your career to the next...in the United States. In this role as Medical Director MPO (Medical Policy & Operations) you will be… more
- Aveanna (Fort Myers, FL)
- …the client's physician, therapists or other care givers. + Provide input to the Medicare Director regarding the need for formulation or modification of agency ... + Master's degree in Social Work preferred As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
- Centers Plan for Healthy Living (Bronx, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing PHYSICAL REQUIREMENTS: The physical requirements described ... healthy living. JOB SUMMARY : The Licensed Benefits Advisor- Medicare Sales, Maintains relationships, services our existing customers and...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Brookdale Senior Living (Mcfarland, CA)
- …other team members to establish appropriate level of care in accordance with Medicare /Medicaid reimbursement levels. + Assists the Director , Clinical Services in ... grow within a leadership role? Our Brookdale Riverwalk is looking for an Assistant Director of Nursing for our skilled nursing unit. Ideal candidate must be an RN… more