- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and ... Programs to optimize the programs' clinical benefit, financial accuracy and ensure program compliance with governing bodies' regulations, including the Center for … more
- The Cigna Group (Bloomfield, CT)
- …This is a critical position on the NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment. Experience with ... 40% of Cigna's total medical cost savings. The **NANPM Medicare Senior Advisor** is responsible for negotiating...and internal business partners and to review vendor / program performance + Monitors and understand Cigna HealthSpring programs,… more
- CVS Health (Hartford, CT)
- …health care more personal, convenient and affordable. **Position Summary:** As the FP&A Medicare Finance Local Market Senior Analyst, you will work closely with ... aid in the communication of performance to the Chief Medicare Officers. In this role, you support the Lead... Officers. In this role, you support the Lead Director to gather insights into business performance and help… more
- Buchanan County Health Center (Independence, IA)
- Program Director Job Purpose The ...of anything that might impact the hospital, patients or Senior Life Solutions in a timely manner - Ensure ... meets Psychiatric Medical Care's (PMC) standards. Supervisor of the program staff, the Program Director 's...all rules associated with the federal government such as Medicare are followed. - Be prepared for surveys by… more
- Martin's Point Health Care (Portland, ME)
- …certified as a "Great Place to Work" since 2015. Position Summary The Senior Director Clinical Programs provides oversight and coordination of care management ... and analysis for the Martin's Point Health Plan. The Senior Director is responsible for Care Management...will work closely with VP of Health Plan Clinical Program and Director of Health Management to… more
- The Cigna Group (Atlanta, GA)
- …Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director , this individual ensures the effective ... network for his/her assigned sub-market and/or provider groups. The role of Senior Advisor with the Provider Performance Enablement team takes ownership for… more
- University of Michigan (Ann Arbor, MI)
- …oversight of Michigan Medicine?s (?MM?) statewide Corporate HIPAA Compliance Program (? Program ?). The Senior Director ?s responsibilities include, but are ... Now **Job Summary** The Senior Corporate Compliance Director (? Senior Director ?) is responsible...to, developing, implementing, and overseeing the Corporate Compliance HIPAA Program to ensure adherence to Federal and State healthcare… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for ... for all of Sharp Health Plan products, (Commercial, Exchange, Medicare , POS/PPO) services, and oversees the health care needs...the Utilization/Cost Management Program and Quality Improvement Program , in conjunction with the Director of… more
- ChenMed (Detroit, MI)
- …is a transitional position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical ... Director and Center Operations + ChenMed Leadership Pathways Program + Medical Economics and Center Financial Performance +...to increasingly assume the role and responsibilities of a Senior Medical Director , which may include: +… more
- Walgreens (Deerfield, IL)
- …"An Equal Opportunity Employer, including disability/veterans". **Job ID:** 1494367BR **Title:** Senior Director , Walgreens 340b Program **Company ... intelligence on competitors entering or expanding in the 340B program in a way that is customer-centric and supports...+ Knowledge of 340B and FFS Medicaid, managed Medicaid, Medicare Parts A,D, and Advantageregulations and their applicability and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the creation of controls to manage fraud, waste and abuse schemes. + Support the Medicare compliance program by overseeing Medicare fraud waste and abuse ... national antifraud associations. The attorney will also oversee compliance for the Medicare and Federal Employee programs related to FWA and respond to Compliance,… more
- LA Care Health Plan (Los Angeles, CA)
- Associate Counsel III Senior Director Health Care Legal Services Job Category: Management/Executive Department: Health Care Legal Services Location: Los Angeles, ... net required to achieve that purpose. Job Summary The Associate Counsel III Senior Director Health Legal Services is responsible for diverse legal activities.… more
- Gilead Sciences, Inc. (Washington, DC)
- …more than 35 countries worldwide, with headquarters in Foster City, California. ** Senior Director , Federal Government Affairs** **Job Overview:** Reporting to ... the Vice President of Federal Government Affairs, the Senior Director , Federal Government Affairs will play an integral role in developing and implementing… more
- Arvinas (New Haven, CT)
- …**Position Summary** As a key member of the Market Access Leadership team, the Senior Director , US Pricing & Contracting Strategy will lead the function ... responsibilities of this role include, but are not limited to: + Provides senior management and cross functional team members with relevant pricing and reimbursement… more
- Magellan Health Services (Albuquerque, NM)
- … and Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health care by ... ECFMG and FLEX examinations. Full training in a residency program in the United States or Canada that is...continuous quality improvement (CQI) processes. General Job Information Title Senior Medical Director , Behavioral Health - New… 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 ... a share of special clinical investigations and research as requested by the Senior Medical Director , Medical Affairs. These projects can include brief reviews… more
- Kepro (Albany, NY)
- …a vital partner for health solutions in the public sector. Acentra is looking for a Program Director to join our growing team. Job Summary: As a Program ... projects are delivered on schedule and within budget. The Program Director works with the customers, functional...and problems from the customer perspective. + Collaborates with senior leadership to align program with business… more
- Fallon Health (Springfield, MA)
- …in quality and management committees as assigned. + Works closely with the SE Senior Director of Operations in the development and ongoing monitoring of ... and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short....reports concerns in a timely manner to the SE Senior Director of Operations. + Participates in… more
- Conviva (Tampa, FL)
- …of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling a variety of ... health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities...facing and is part of our Tuberculosis (TB) screening program . If selected for this role, you will be… more
- CenterWell (Stone Mountain, GA)
- …of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling a variety of ... health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities...facing and is part of our Tuberculosis (TB) screening program . If selected for this role, you will be… more
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