- CVS Health (Baton Rouge, LA)
- …health care more personal, convenient and affordable. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California,...Better Health Plan of Louisiana. This UM (Utilization Management) Medical Director will be a "Work from… more
- CVS Health (Baton Rouge, LA)
- …Better Health of Louisiana is seeking a dedicated and experienced Behavioral Health Medical Director . The ideal candidate will be a board-certified psychiatrist ... of training in a medical specialty. The Behavioral Health Medical Director will ensure timely medical decisions, including after-hours consultation, and… more
- Humana (Baton Rouge, LA)
- …materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State Medicaid requirements (currently FL; ... caring community and help us put health first** The Medical Director 's primary responsibility is the review...obtain License/s in Indiana, Virginia, Georgia, and/or other LTSS Medicaid states as needed + MD or DO degree… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …the Chief Financial Officer for Medicaid and is a member of the Medicaid Director 's Executive Team. The CFO provides direction and support to the following ... rate setting. Level of Work: Administrator. Supervision Received: Broad direction from Medicaid Director . Supervision Exercised: Direct line over Section Chiefs… more
- CVS Health (Baton Rouge, LA)
- …suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Lead Director of Medicaid Risk ... the Market Manager will work closely with cross-functional leadership across the Medicaid business to establish and champion a local market culture committed to… more
- CVS Health (Baton Rouge, LA)
- …and affordable. **Position Summary** As the Manager, FP&A, you will report directly to Director of Finance and will monitor the end to end profit & loss statements, ... by both the state and the Illinois Association of Medicaid Health Plans regarding the marketshare, data submission for...data submission for the purpose of rate setting and medical trend analysis on behalf of the Health Plan.… more
- Humana (Baton Rouge, LA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Baton Rouge, LA)
- **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
- Humana (Baton Rouge, LA)
- **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 reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Baton Rouge, LA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- CVS Health (Baton Rouge, LA)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...Qualifications** Internal Medicine background Have experience in Medicare and Medicaid **Education** *M.D. or DO, Board Certification in an… more
- Evolent (Baton Rouge, LA)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person"… more
- Evolent (Baton Rouge, LA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person"… more
- Humana (Baton Rouge, LA)
- …of our caring community and help us put health first** The Director , IT Vendor Management establishes and implements hardware and software acquisition, protection, ... and procedures that are aligned with IT standards and strategy. The Director , IT Vendor Management requires an in-depth understanding of how organization… more
- Humana (Baton Rouge, LA)
- …our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and ... and unstructured data to insights at enterprise scale. The Associate Director , Cloud Architecture requires an in-depth understanding of how organization capabilities… more
- Humana (Baton Rouge, LA)
- …of our caring community and help us put health first** The Director , BH Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other ... provider contracts and agreements with behavioral health providers. The Director , BH Provider Contracting requires an in-depth understanding of how organization… more
- Humana (Baton Rouge, LA)
- …of our caring community and help us put health first** The Associate Director , Actuarial provides actuarial support across a broad range of actuarial and business ... needs for specific product lines. The Associate Director , Actuarial requires a solid understanding of how organization capabilities interrelate across department(s).… more
- United Therapeutics (Baton Rouge, LA)
- …orphan diseases. **How you'll contribute** The Associate Analytics, Insights and Operations Director , Market Access will lead data support across all functions of ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …60%Manages, implements, and performs oversight of the statewide delivery of the Medicaid -funded specialized behavioral health services by the health plans and CSoC ... case management, and adverse incident management. Provides direction and support to Medicaid staff to develop, implement, and analyze reports that fall outside OBH… more
- Mathematica (Baton Rouge, LA)
- …of data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more