- Elevance Health (Woodbridge, NJ)
- ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- RWJBarnabas Health (Oceanport, NJ)
- …filings. In partnership with the Senior Vice President of Office of Reimbursement, the Director will manage the completion of DSH, Medicare Bad Debts, Wage ... Director , Corporate Reimbursement (Hybrid/Remote) - Oceanport, NJReq #:0000180233...as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment… more
- Molina Healthcare (New York, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Mount Sinai Health System (New York, NY)
- …environments * Seek to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible ... to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- FlexStaff (New York, NY)
- **Req Number** 146159 FlexStaff FlexStaff is seeking a Regional Medical Director for our client, a non-profit healthcare organization dedicated to providing home ... we encourage you to apply. Overview: As the Regional Medical Director , you will be responsible for...direct participant contact. - Must possess a Medicaid and Medicare Provider ID in good standing. *Additional Salary Detail… more
- Ascendis Pharma (Princeton, NJ)
- …mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly ... develop their skills. Ascendis Pharma is looking to hire an experienced Director , Contract Operations to join our team. Responsibilities will include implementing… more
- CVS Health (New York, NY)
- …Candidates must reside within commutable distance from a CVS or Aetna office.** The Medicare Stars and Health Equity team is seeking a Lead Dir, Health Equity & ... expanding on equity-based clinical and member experience initiatives leveraging existing Medicare product portfolio. Collaborate closely with the Medicare … more
- Mount Sinai Health System (New York, NY)
- …is responsible for evaluating and driving performance for value-based contracts including Medicare , Medicaid and commercial arrangements. The Senior Director is ... including Powerpoint and Excel Results orientation with working knowledge of medical economics analytics Understanding of CMS programs and concepts (eg, Star… more
- CVS Health (New York, NY)
- …and affordable. **Position Summary** The Web Channel Owner role for Aetna Medicare is a critical position in our Marketing organization, with accountability for ... shepherd the delivery of Digital Marketing's capabilities backlog for Aetna.com/ Medicare , AllinaHealthAetnaMedicare.com, the Shop, Buy, and Enroll tool, and more,… more
- City of New York (New York, NY)
- …position on Medicaid redesign policy and innovation. Advise and assist OSHSSA Executive Director , Chief Medical Officer and other agency executives on healthcare ... and clinicians. The Bureau of Equitable Health Services seeks to hire a Director of Healthcare Payment & Financing Initiatives. DUTIES WILL INCLUDE BUT NOT BE… more
- Genesis Healthcare (Piscataway, NJ)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of...in the state of practice 3. Thorough knowledge of Medicare and third party billing required 4. Must have… more
- Molina Healthcare (New York, NY)
- …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
- VNS Health (Manhattan, NY)
- …of individual grievances and appeals. Consults with enrollees, providers and the Medical Director , as appropriate. + Provides input and recommendations for ... operations and customer service. + Reviews information available from Medicaid, Medicare , other payers, and/or professional medical organizations regarding… more
- Hackensack Meridian Health (Eatontown, NJ)
- …agreements are up-to-date and assists with preparation for site visits. + Ensures Medical Billing/ Medicare Billing claims are processed and posted and follows up ... with new vendor contracting, and re-credentialing as needed with PBMs, Medicare , Medicaid, and other payers/entities. **Responsibilities** A day in the life… more
- Hackensack Meridian Health (Wall, NJ)
- …network. Some responsibilities include the preparation of advanced sections of the Medicare and NJDOH cost reports, completion of advanced reimbursement studies and ... and support staff supervision and training. Also responsible for Monthly Medicare reconciliation and assists in completion of monthly third party review.… more
- Penn Medicine (Plainsboro, NJ)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... Are you living your life's work? Summary: + The Nurse Manger assists the Director in managing the daily operations of the department with direct responsibility of… more
- Hackensack Meridian Health (Neptune, NJ)
- …facilitates improvement in the overall quality, completeness and accuracy of medical record documentation for assigned hospital/s of Hackensack Meridian Health ... patient status. Facilitates accurate documentation for severity of illness and medical necessity. Interacts with physicians, case managers, and nursing staff and… more
- VNS Health (Manhattan, NY)
- …staff at all levels including but not limited to, Provider Relations, Claims, Medical Director , third party administrator, pharmacy benefit manager, to achieve ... and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health product lines. *...Health insurance plan for you and your loved ones, Medical , Dental, Vision, Life and Disability + Employer-matched retirement… more
- City of New York (New York, NY)
- …PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Medical Assistance Program (MAP) administers public health insurance programs, including ... health care services at little or no cost. The Medical Assistance Program is recruiting for one (1) Principal...will, under the general direction of the Excess Income/Surplus Director , with wide latitude for the exercise of independent… more
- City of New York (New York, NY)
- …health outcomes for all New Yorkers. CHECW sits under the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems (BEHS) is the healthcare systems ... health outcomes for all New Yorkers. CHECW sits under the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems (BEHS) is the healthcare systems… more