- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work The Medical Director 's work includes computer-based review of...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- CVS Health (Tallahassee, FL)
- …of Florida primarily, and the Southeast Region (KY, LA and WV). This Medical Director will be a "Work from Home" position primarily supporting the Aetna ... health care more personal, convenient and affordable. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6… more
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: Under the direction of VP Operations, CNO, the Regional Director of Case Management is responsible for the development, implementation, and/or ... service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. . Knowledge of medical… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is responsible for managing the payor contracting functions for the hospitals, ... medical centers, urgent care centers, and employed physicians of...including direct to employer relationships and commercial, Medicare Advantage, Medicaid HMO, and other governmental payors. 4. Routinely evaluate… more
- Henry Ford Health System (Troy, MI)
- …background, preferred. * Ability to work with and interpret detailed medical record documents and communicate effectively with physician, nursing staff, leadership ... and other HFH personnel. * Knowledge of medical coding (facility and professional), related medical ...state regulations related to rules/coverage. * Knowledge of Medicare, Medicaid , Blue Cross and other third-party payers billing and… more