- Robert Half Legal (Alpharetta, GA)
- …role within the healthcare industry. The hire will be responsible for maintaining compliance with Medicaid and HIPAA regulations and overseeing enterprise risk ... within a healthcare or government contracting organization * Oversee the compliance with Medicaid and HIPAA regulations, as well as other applicable federal and… more
- Elevance Health (Tampa, FL)
- RN Utilization Management Nurse Sr . ( Medicaid -InPatient) JR130851 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This is ... **or** 4/10 hour shifts to include a weekend day. The **Nurse Medical Management Sr ** serves as T **eam Lead** for nursing staff who collaborate with healthcare… more
- Johns Hopkins University (Middle River, MD)
- …analysis, consultation, and reports to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS). Reviews provider ... questions and to clarify various billing concerns. Researches and resolves compliance issues. Maintain strict confidentiality of staff and patient information. Will… more
- Elevance Health (Tampa, FL)
- Job Description **Nurse Medical Management Sr .** **Preferred Location** : Florida. **This position will work 100% remote (with the exception of team meetings which ... miles of one of our Elevance Health PulsePoint locations. **Nurse Medical Management Sr .** Responsible to serves as team lead for nursing staff who collaborate with… more
- Gilead Sciences, Inc. (Seattle, WA)
- …the lives of patients with life-threatening illnesses worldwide. As the ** Senior Director, Field Reimbursement Management (FRM)** for HIV Prevention, you will ... therapies by leading a nationwide team of Regional Field Reimbursement Directors (TBD) and Field Reimbursement Managers (FRMs). This position will drive… more
- Humana (Tampa, FL)
- …for all enterprise partners + Drive Operational Quality Assurance efforts to ensure Medicaid compliance , including a Medicaid Compliance Committee, ... + Business Intelligence and reporting to state partners + Compliance for contractual obligations across all Medicaid ...of approximately 6 direct reports, including VPs, AVPs, and Directors with more than 200+ associates in the organization.… more
- Magellan Health Services (Albuquerque, NM)
- …the clinical vision for the health plan(s) for all lines of business ( Medicaid , Medicare and Commercial) and implements and manages programs to support this vision. ... The Senior Medical Director ensures the delivery of appropriate health...care. Monitors and oversees the work of the Medical Directors and Physician Advisors in providing cost-effective and quality… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and its programs remain compliant with Centers for Medicare and Medicaid Services (CMS), Organ Procurement and Transplantation Network (OPTN)/United Network for ... to monitor metrics and audit reports to ensure data integrity, policy compliance , and patient safety reporting both internally and externally, to appropriate… more
- DESC (Seattle, WA)
- …Responsibilities:** + In coordination with the Executive Director and other senior directors , assume responsibility for the planning, implementation, operation, ... Senior Director of Clinical Programs Seattle, WA (http://maps.google.com/maps?q=515+Third+Avenue+Seattle+WA+USA+98104) *Clinical Administration Apply Job Type… more
- DESC (Seattle, WA)
- …contract compliance , reports, quality improvement and training and assist Sr . Managers in strengthening their portfolios. + Have working knowledge of state ... Director is a leadership position in DESC's Clinical department, reporting to the Senior Director of Clinical Programs and collaborating with the Director of Mobile… more
- City of New York (New York, NY)
- …continued compliance with accreditation requirements - Collaborate with program directors across the country via American College of Preventive Medicine (ACPM) - ... color. We are looking to recruit a Preventive Medicine Residency Director and Senior Population Health Physician. This role demands a combination of roles, including… more
- Dr. Reddy's Laboratories (Remote, OR)
- …a less traditional background. **Job Description** We are seeking a Director / Senior Director National & Regional Payer Accounts to lead the execution of market ... + Establish strategic relationships with key stakeholders including Medical and Pharmacy Directors within assigned Accounts and educate all on Dr. Reddy's biologic… more
- UTMB Health (Galveston, TX)
- …the Regional Women's Services and Pediatrics (RWSP) Grants and Governance reports to the Sr . VP of Ambulatory Operations of the UTMB Health System. The Director is ... + In collaboration with Director of Clinical Operations and ambulatory directors , determines, monitors and ensures that productivity and utilization goals are… more
- CVS Health (Sacramento, CA)
- …(eg, specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance , Legal, Accreditation) and clients. The Medical Director (Medical ... to UM transactions and more generally related to CVS Health coverage policies. Medical Directors at CVS Health are encouraged to model the highest levels of clinical… more
- CAMBA (Brooklyn, NY)
- …and procedures applicable to HealthLink program. + Meet and work with the other Senior Program Directors to discuss any findings and implement changes. + Assist ... of medical, psychiatric, behavioral health, social service and housing providers. Funded by Medicaid and pursuant to contracts with two New York State Health Homes,… more
- Stanford Health Care (Palo Alto, CA)
- …clinical compliance program that includes but is not limited to ensuring compliance with Medicare and Medicaid billing regulations, fraud and abuse laws, ... of the SHC, SMCH, and other related Boards of Directors , and reports administratively to the Stanford Chief Risk...of conduct related to compliance . + Stewarding compliance committees comprised of senior SHC/SMCH leaders.… more
- Sanofi Group (Cambridge, MA)
- …of pricing innovation and excellence. + Lead and manage 9 high performing pricing Directors and Sr . Directors across Specialty Care [Alliance and ... for all of Sanofi's Pharma business [General Medicines & Specialty Care]. This senior leadership position will manage a talented team of pricing individuals across… more
- HCA Healthcare (Tampa, FL)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... Patient Access Director, you will be responsible for hospital-based Patient Access Directors who manage daily operations of all Patient Access functions. You will… more
- AdventHealth (Maitland, FL)
- …to Senior Staff, AdventHealth Florida and Multi-State Managed Care Directors and Ancillaries. * Accountable for ensuring Payer updates (policy, system edits, ... and Ancillaries. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms. This affords AdventHealth… more
- Hawthorne Foundation Inc. (Hawthorne, NY)
- …OPWDD and NYSED financial rate setting, billing and reimbursement and of Medicaid compliance regulations. Strong experience managing government contracts. Strong ... NYSED and Medicaid regulations, an understanding of advanced accounting, SSI/SSA Compliance , knowledge of financial IT systems, and ensuring compliance with… more