- AmeriHealth Caritas (Newtown Square, PA)
- …of Medicare Care Management and the Chief Medical Officer, the Corporate Director , Population Health Medicare Clinical Operations is responsible for ... **Corporate Director , Population Health Clinical Operations, Medicare ** Location: Newtown Square, PA Primary Job Function: Medical Management ID**: 37990… more
- Humana (Columbus, OH)
- … Director relies on medical background and reviews preauthorization requests for services . The Medical Director work assignments involve moderately complex to ... or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation… more
- Elevance Health (Columbus, OH)
- …(formerly IngenioRx) leverages the power of new technologies and a strong, clinical -first lens, to deliver member-centered, lasting pharmacy care. In this pivotal ... role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director is tasked with the responsibility of developing, preserving and… more
- 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...Director Associates. May be responsible for an entire clinical program. **How you will make an impact:** +… more
- Molina Healthcare (Long Beach, CA)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + ... that guide and support the provisions of medical staff services . Maintains a working knowledge of applicable national, state,...including: + 2 years previous experience as a Medical Director in a clinical practice. + Current… 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 ... sends a personal message that how we deliver our services is just as important as what we deliver....transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Medicare Clinical Pharmacist will work with the Medicare Quality team to support Priority Health's Medicare Stars initiatives. The ... the patient's needs and goals + Identify and provide clinical recommendations to patients, caregivers, and/or providers that address...+ Perform other duties assigned by the Manager of Medicare Quality of Director of Medicare… more
- Brookdale Senior Living (Sarasota, FL)
- …care in accordance with Medicare /Medicaid reimbursement levels. + Assists the Director , Clinical Services in ensuring comprehensive and accurate ... us for at least a year. Responsibilities Assists the Director , Clinical Services in planning,...recommendations for Success Planning to include conducting and scheduling in- service training classes that provide instruction of clinical… more
- Point32Health (Canton, MA)
- …and timelines. The Senior Manager works closely with claims, membership operations, clinical services , care management, customer relations, sales, marketing, and ... enjoy the important work we do every day in service to our members, partners, colleagues and communities. To...senior leadership, the Senior Manager, in collaboration with the Director , is responsible for all necessary product filings with… more
- Brookdale Senior Living (Littleton, CO)
- …care in accordance with Medicare /Medicaid reimbursement levels. + Assists the Director , Clinical Services in ensuring comprehensive and accurate ... close within 30 days of the date of the posting. Responsibilities Assists the Director , Clinical Services in planning, organizing, developing and directing… more
- BrightSpring Health Services (Baltimore, MD)
- …driver's license from state of residence Knowledge/Skills/Abilities: + Extensive knowledge of Medicare home health requirements, clinical service delivery, ... achieve the highest quality of care for patients. Oversees the delivery of clinical services recommending best practice implementation optimal clinical … more
- The Arc Erie County NY (Williamsville, NY)
- …and guidelines. Reporting Relationship: Receives administrative and program supervision from the Director of Clinical Services or designee; provides direct ... for assigned programs under the supervision of the Associated Director of Clinical Services ; assures...Services field PLUS three years full-time paid direct service experience with developmental disabilities of which one year… more
- Jet Health (Denton, TX)
- Director of Clinical Services - Hospice Denton, TX, TX (http://maps.google.com/maps?q=2214+Emery+Street,+Suite+410+Denton+TX+USA+76201) Job Type Full-time ... times. We are seeking an experienced and dynamicDirector of Clinical Services (RN)to join our team and...with regulatory standards while delivering excellent patient care. The Director will manage the activities of the nursing team,… more
- BrightSpring Health Services (Arlington, TX)
- …+ Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager + Provide clinical support to ... This vital role serves as a key point of contact for the Clinical Hub and proactively communicates with Pharmacists, Facilities, Physicians and PDP's regarding… more
- Aveanna (York, PA)
- …organizing, directing, and evaluating nursing services in their locations. The Clinical Director operates within federal, state, and local home health ... Clinical Director - Registered Nurse ApplyRefer...standards, ensuring the delivery of high-quality and compliant nursing services . Contribute to retention initiatives by fostering a supportive,… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN/LPN clinical reviewers as ... well as Support staff managing all areas of clinical claim pre and post audit, appeals submission, and...and customers to drive improvement in the quality of services delivered to patients. Responsibilities * Audits patients records… more
- Aveanna (Fort Wayne, IN)
- …and evaluating nursing services of nursing location (non-PDHC offices). The Clinical Director (CD) is responsible for the management of all operational ... Clinical Director - RN - Home... services for their location of responsibility. Working within the...or without notice. Vaccination Requirements As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Texas A&M University - Faculty (Dallas, TX)
- Academic Professional Track (Non-Tenure): Open Rank Clinical & Director of Clinical Compliance College of Dentistry Location Dallas, TX Open Date 11/13/2024 ... Professor. This position will include an administrative appointment as Director of Clinical Compliance and t he...of managing patient care, HIPPA compliance, and centers for Medicare and Medicaid Services . Eligible for… more
- Pennsylvania State University (Hershey, PA)
- …CTO empowers our study teams to excel in their research endeavors. The Assistant Director , College of Medicine Clinical Trials Office (CTO Assistant Director ... budgets. Develop COM CTO strategic plan with COM CTO Director . + Evaluate and review clinical trials...College of Medicine Controller's Office, PSH Finance, Patient Financial Services , PSU Risk Management, Legal counsel, Clinical … more
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