• Medical Director - Medicaid

    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 (12/06/24)
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  • Medical Director - Behavioral Health…

    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
    CVS Health (01/07/25)
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  • Director , Medicaid Trend Mitigation…

    Humana (Baton Rouge, LA)
    …part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify ... for business segments or the company at large. The Director , Medicaid Trend Mitigation Strategy requires an...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (01/08/25)
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  • Medicaid Deputy Director

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …rate setting. Level of Work: Administrator. Supervision Received: Broad direction from Medicaid Director . Supervision Exercised: Direct line over Section Chiefs ... Medicaid Deputy Director Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4786614) Apply...is located within the Louisiana Department of Health / Medical Vendor Administration / Director 's Office/Executive Management… more
    Louisiana Department of State Civil Service (01/11/25)
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  • Medicaid Program Manager 3

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …appropriate action to Rate Setting and Audit Section Chief, Medicaid Deputy Director -CFO, Medicaid Director , and Hospital and Facility Finance ... implementation and to provide recommendations to the Section Chief, Medicaid Deputy Director -CFO, Medicaid Director and the Hospital and Facility Finance… more
    Louisiana Department of State Civil Service (01/08/25)
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  • Medicaid Program Manager 2

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …This position is located within the Louisiana Department of Health / Medical Vendor Administration / Director 's Office/Executive Management Team/ East Baton ... Medicaid Program Manager 2 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4782730) Apply  Medicaid Program Manager 2 Salary $5,477.00 -… more
    Louisiana Department of State Civil Service (01/09/25)
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  • Manager, Medicaid Risk Adjustment

    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 (01/04/25)
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  • Medical Director - Florida

    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 (12/14/24)
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  • Medical Director - South Central

    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 (11/08/24)
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  • Medical Director - National Medicare…

    Humana (Baton Rouge, LA)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical more
    Humana (11/08/24)
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  • Medical Director - Mid West Region

    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 (10/29/24)
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  • Medical Director - OneHome/Home…

    Humana (Baton Rouge, LA)
    …our caring community and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (12/21/24)
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  • Medicare Grievances and Appeals Corporate…

    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
    Humana (01/07/25)
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  • Medical Director - Commercial…

    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
    CVS Health (11/13/24)
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  • Field Medical Director , Cardiology

    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 (11/15/24)
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  • Field Medical Director -ENT

    Evolent (Baton Rouge, LA)
    …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
    Evolent (12/09/24)
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  • Associate Director Cloud Architecture

    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 (11/02/24)
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  • Associate Director , Actuarial

    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
    Humana (12/12/24)
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  • Director , IT Portfolio Management…

    Humana (Baton Rouge, LA)
    …part of our caring community and help us put health first** The Director , IT Portfolio Management for Enterprise Information Protection (EIP) develops and executes ... technology and innovation to improve and mature Humana's security posture. The Director develops and executes on programs defined to implement security controls,… more
    Humana (12/14/24)
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  • Director , Insurance Strategy

    Humana (Baton Rouge, LA)
    …**Location:** remote The Insurance Strategy team supports Humana's Medicare and Medicaid lines of business. This business unit, Humana's largest, comprises the ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
    Humana (12/21/24)
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