- Molina Healthcare (Madison, WI)
- …requests for proposals (RFPs). + Contributes to the development and implementation of behavioral health medical policies, peer review processes, provider ... the medical necessity, appropriateness, and quality of behavioral health services (mental health ...health and at least 3 years as a medical director in a managed care setting… more
- Humana (Madison, WI)
- … Medical Director to integrate the administration and management of behavioral and physical health services + Oversees, monitors, and assists with ... and help us put health first** The Chief Psychiatrist oversees our behavioral health (BH) clinical program for our Illinois FIDE members. The individual… more
- Highmark Health (Madison, WI)
- …**JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and knowledge to the team. They support ... the full-cycle ownership of commercial and Medicare Advantage medical policies, both developed internally and by vendors. This...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Madison, WI)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- CenterWell (Madison, WI)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** The Director , Home Health...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- CenterWell (Madison, WI)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** The Associate Director , Product Management...or in-practice role (eg, Center Administrator, Front Office, Scheduling, Medical Assistant, Physician, or Physician Extender). + Two or… more
- Highmark Health (Madison, WI)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Analytics, Contracting, Market and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- Sevita (Madison, WI)
- …reviews data and attests to accuracy; submits accurate data to the Program Director or appropriate billing authority. ** Health Care:** 1. General Health ... Monitors health of persons being served; documents; communicates with medical professionals as appropriate; implements preventive strategies to limit illness and… more
- GN Hearing (Madison, WI)
- …Territory Sales Manager **Reports to Title:** Regional Sales Director **Department/Division:** Sales **Primary Work Location:** Wisconsin **Job Code/Classification** ... business plan. The plan should be reviewed and updated quarterly with regional director and inside sales counterpart. Plan should include: + Sales growth that… more