- Humana (Columbus, OH)
- …analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides ... caring community and help us put health first** The Medical Director relies on medical ...or Surgery specialties + Utilization management experience in a medical management review organization, such as Medicare … more
- AdventHealth (Altamonte Springs, FL)
- …and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital ... with the preparation of work papers for the filing of the annual Medicare , Medicaid, and Champus/Tricare cost reports, audit preparation and other cost report… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation... Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify … more
- Humana (Columbus, OH)
- …and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- St Croix Hospice (Oakdale, MN)
- Regional Medical Director Job Details Job Location Administration - OAKDALE, MN Job Posting Date(s) Start Date 11/07/2024 Description Responsible to the Chief ... responsibility for the medical component of the agency's program. The Regional Medical Director manages the Hospice Physicians for the PTAN/NPI in which they… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons...medical issues and departmental responsibilities. Assists in monitoring, reviewing , and evaluating the quality of health care services… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** The Medical Director of Mental Health is a psychiatrist who oversees mental health services in the Medical Network and provides support ... mental health needs of patients cared for across the Medical Network. The Medical Director ...including maintaining the network of providers for the CSMN Medicare Advantage plan(s). + Assists Contracting with identification, engagement,… more
- Henry Ford Health System (Detroit, MI)
- The Medical Director of Utilization Review is responsible for the medical oversight of activities related to appropriateness of Henry Ford Hospital (HFH) ... of hospital resources, and continued stays of inpatients. The Medical Director of utilization review will ensure... Officer for Henry Ford Hospital. Role includes: 1. Medicare two midnight self-audits required to maintain compliance with… more
- Dartmouth Health (Keene, NH)
- …reviews, educating physicians on medical necessity for inpatient/outpatient services, reviewing Medicare Condition Code 44 downgrades, Medicare Outliers ... Overview Associate Medical Director - Cheshire Hospital Medicine Physician Advisor The Cheshire Medical Center’s Department of Hospital Medicine is a… more
- LifePoint Health (Bullhead City, AZ)
- …in the development of root cause analyses (RCA) as directed by the CNO.The Director is responsible for reviewing and formulating policy or organizational changes ... in good standing. Multi-State Licensure accepted. **Job:** **Quality* **Organization:** **Valley View Medical Center* **Title:** * Director Quality & Risk Mgmt -… more
- HCA Healthcare (San Antonio, TX)
- …and wait list volumes and spin-off activity. + Works effectively with program Medical Director , ensuring strong lines of communication and follow-up, and jointly ... We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Administrative Director of Bone Marrow Transplant… more
- Genesis Healthcare (Charleston, WV)
- …contracted physicians, medical directors, contracted APPS, specialty consultants, medical director agreements with Operators/Centers. + Identifies, develops, ... medical directors. + Works closely with Regional Medical Director (RMD) to create a plan...progress with satisfying requirements to be eligible for the Medicare Shared Savings Program (MSSP) including but not limited… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …+ Develop and administer inter\-reviewer reliability methodology to ensure medical necessity determinations are consistent with CMS published guidelines corporate ... medical review criteria, and medical policy guidelines\....interpret and explain complex government policies + Knowledge of Medicare programs Employees who are required to operate either… more
- Mount Sinai Health System (New York, NY)
- …costs down. + Collaborates with the Legal Department in creating, modifying and reviewing contractual documents for provision of medical services at affiliate ... **Job Description** **Job Title: Executive Director - Social Services - MSH - Full...necessary. He/she collaborates with the President, Vice President, Chief Medical Officer, and other senior leadership/faculty members in the… more
- State of Indiana (Indianapolis, IN)
- Adult Protective Services Director Date Posted: Nov 25, 2024 Requisition ID: 452420 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career ... statewide INconnect Alliance network. Role Overview: The Adult Protective Services (APS) Director provides leadership to and oversight of the APS Team, providing… 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, CA, ... to achieve that purpose. Job Summary The Associate Counsel III Senior Director Health Legal Services is responsible for diverse legal activities. This position… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- The Senior Director , Scientific Marketing, will contribute to the financial success of Injection Brand and will report to the Executive Director , Marketing. This ... in close collaboration with Clinical, Med Affairs and Field Medical to ensure alignment with overall brand and ...would be a plus + Proven track record in reviewing , understanding clinical data and developing scientific marketing strategies… more
- Lilly (IN)
- …who are determined to make life better for people around the world. The **Sr. Director -** **Counsel - Litigation, Legal Policy & Strategy** role is for a creative, ... policy and strategy priorities and litigation, including assistance drafting and reviewing communications, comment letters, and related materials. + Lead outside… more
- BAYADA Home Health Care (Tucson, AZ)
- …Services: Hospice Physician shall perform those services appropriate to the position of medical director of a hospice, which includes, but are not limited ... Documentation and Timesheets. Complete timesheets and maintain documentation on all Medical Director Services provided in accordance with Hospice's policies… more
- MyFlorida (Chattahoochee, FL)
- … and Fiscal Services. AMS - Work under the direction of the Ancillary Medical Services Director , with the Medicare /Medicaid Coder, Financial Services, ... fact finding research and reporting of various information, understanding Medicare /Medicaid practices and policy. Must be proficient in Excel...bills for review by Ancillary Medical Services Director and Medical Director prior… more
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