- Humana (Denver, CO)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources which… more
- Humana (Denver, CO)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources, which...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will… more
- Humana (Denver, CO)
- …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 ... Corporate Medical Director reviews cases of diverse scope and complexity ranging...and appropriateness of services rendered by healthcare professionals in compliance with CMS guidelines, clinical coverage criteria, and quality… more
- Humana (Denver, CO)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
- Humana (Denver, CO)
- …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 ... requires an in-depth evaluation of variable factors. **Job Profile** The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Denver, CO)
- …**Additional Information** Typically reports to a Lead, may also report to a Regional/ Associate Vice President or Corporate Medical Director , depending on size ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- State of Colorado (Golden, CO)
- Clinical Director - Summit Youth Services Center in Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4647829) Apply Clinical Director ... in DYS committees as needed; Participation in division-wide clinical director meetings; Ongoing communication with client managers/parole officers regarding… more
- Humana (Denver, CO)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Humana (Denver, CO)
- …us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and document ... work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality audits, prior authorization list… more
- BrightSpring Health Services (Englewood, CO)
- …home infusion providers in the country. The Collection Manager will report to the Director of Revenue Cycle Management. This position can be hybrid OR fully remote. ... The Collection Manager will assure that the reimbursement department maintains compliance with company policies and all applicable laws and regulations regarding… more
- State of Colorado (Denver, CO)
- …of and adhere to prevailing legal standards, CDHS Policy, DYS Policy, DYS Compliance Review Standards. Adheres to CDHS and DYS Policy regarding work schedule, ... name check and fingerprint check, ICON Colorado court database, Medicare fraud database, Reference Checks, Professional License verification (licensure… more
- State of Colorado (Golden, CO)
- …name check and fingerprint check, ICON Colorado court database, Medicare fraud database, Reference Checks, Professional License verification (licensure ... Board or request a review by the State Personnel Director . An appeal or review must be submitted on...sociology or criminal justice major or similar field). + Associate 's degree with Major in (psychology, sociology or criminal… more
- Adams County Government (Brighton, CO)
- …(4) days per week based on the County needs and as determined by Department Director . Hybrid classified roles can be onsite more than the set minimum based on ... work involved in the administration of the Adams County benefit programs, early retiree/ Medicare programs, leave of absence and ADAAA. Examples of Duties for Success… more