- Humana (Denver, CO)
- …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical ... 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
- Humana (Denver, CO)
- …and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and... Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify … more
- Humana (Denver, CO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Denver, CO)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Conviva (Denver, CO)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Denver, CO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Evolent (Denver, CO)
- …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. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Humana (Denver, CO)
- …a part of our caring community and help us put health first** The Director , Market Finance is a financial leadership position with a significant focus on strategy ... and operations. The Director , Market Finance requires an in-depth understanding of how...work closely with the RVP, Operations, including exposure to Medicare Advantage bid strategy, regional operations staffing, and administrative… more
- Humana (Denver, CO)
- …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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Evolent (Denver, CO)
- …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. ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- CVS Health (Denver, CO)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
- University of Colorado (Aurora, CO)
- **Finance & Accounting Assistant Director ** **Description** **University of Colorado Anschutz Medical Campus** **Department: College of Nursing** **Job Title: ... Finance & Accounting Assistant Director ** **Position #: 00706656 - Requisition #:35706** **Job Summary:**...and patient visit reporting. + Coordinates and submits annual Medicare and Medicaid cost reports, quarterly audit and reporting… more
- Evolent (Denver, CO)
- …$64M of savings for Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care / President of Evolent Care Partners and ... Medicare and Commercial contracts, including plans related to medical expense management, quality improvement, appropriate risk adjustment, and patient and… more
- Humana (Denver, CO)
- …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
- CenterWell (Denver, CO)
- …a part of our caring community and help us put health first** The Director , Complex Care Strategy Advancement will play a pivotal role in driving the strategic ... quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will be responsible for assessing the value of… more
- HCA Healthcare (Denver, CO)
- …without reservations or limits? Our HCA HealthOne team is looking for a Director of Regulatory Compliance and Accreditation. HCA Healthcare is an advanced healthcare ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...save lives across the country? Apply today to our Director Regulatory Compliance and Accreditation and be a part… more
- Humana (Denver, CO)
- …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
- Baylor Scott & White Health (Denver, CO)
- …adjudicated claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and ... Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support...Baylor Scott & White Quality Alliance Commercial, DTE, and Medicare (MSSP ACO, Medicare Advantage) lines of… more
- HCA Healthcare (Denver, CO)
- …of care in 21 states and the United Kingdom. We are looking for a Director of Quality and Risk Management for our HCA HealthONE Rose team where excellence creates ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...to be an influencer in healthcare? **Apply for our Director of Quality and Risk Management role today!** **Job… more
- Humana (Denver, CO)
- …our caring community and help us put health first** The Associate Director , Operational Readiness ensures optimized interaction between Humana and its customers ... member PHI / HIPAA information **Preferred Qualifications** + Experience in Medicare and/or healthcare + Off-shore contact center experience + Prior experience… more