- Elevance Health (Hanover, MD)
- ** Director I Medicare Operations ** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... and Medicaid Services to transform federal health programs. The ** Director I Medicare Operations ** is responsible for directing multiple business function… more
- Humana (Annapolis, MD)
- … Director is responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve moderately ... requires an in-depth evaluation of variable factors. The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make… more
- CareFirst (Baltimore, MD)
- …based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the utilization management ... Will be responsible for the Commercial, Federal Employee Program, Medicaid, and Medicare lines of business. Establishes performance metrics to ensure the needs and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Director , Pharmacy Government Programs is responsible for implementing the organization's pharmacy vision and strategic plan ... for government programs ( Medicare and Medicaid). This role has oversight of pharmacy...other key stakeholders including external vendors to ensure effective operations and value realization of government pharmacy programs. This… more
- BrightSpring Health Services (Baltimore, MD)
- …clinician retention through oversight of ongoing staff development. Collaborate with Director , HH Clinical Education to monitor integrity of orientation program, and ... individual development plans + Assists branch leadership in monitoring and analyzing Medicare performance data. Ensures adherence to standards of practice + Delivers… more
- Sunrise Senior Living (Silver Spring, MD)
- …**COMMUNITY NAME** Bedford Court **Job ID** 2024-216274 **JOB OVERVIEW** The Director of Nursing Services is responsible for providing leadership and management ... to the skilled nursing operations . Responsible for planning, organizing and leading overall ...members and targeted referral sources. + Assists the executive director in completing the annual community budget. + Understands… more
- Cardinal Health (Annapolis, MD)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Humana (Annapolis, MD)
- …Medical Director responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve ... Reporting Relationship: This position reports directly to the Cluster Lead Medical Director . **Use your skills to make an impact** **REQUIREMENTS:** + Doctor of… more
- Humana (Annapolis, MD)
- …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 (Annapolis, MD)
- …Best Places to Work, and be a part of our dynamic team as the Director of Technology Solutions. We are on a mission to revolutionize our Customer Relationship ... your chance to make a substantial impact! As the Director of Technology Solutions, you will spearhead the strategy...of IT initiatives that are vital to our business operations . Your deep understanding of organizational capabilities and your… more
- Gentiva (Windsor Mill, MD)
- …in people's lives every day. **Overview** We are looking for an **Executive Director Specialist RN** traveling to many of our offices throughout our East Region ... guidelines. + Registered Nurse required, BSN preferred. + Experience in hospice operations , state and federal regulations and compliance required + Strong regulatory… more
- HealthEdge Software Inc (Annapolis, MD)
- …them: NCQA (National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other ... particularly in the Payer space, with a perspective on how health plan operations impact willingness to adopt digital transformation and innovation + 7+ years'… more
- Option Care Health (Columbia, MD)
- …data to the Regional Nurse Manager, Area Director of Nursing, and/or Director of Operations . Supports the development and implementation of the Plan of ... direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also...office specific continuing education and orientation programs. Assists the Director of Operations , Area Director … more
- Prime Therapeutics (Annapolis, MD)
- …a thorough understanding of operating infrastructure of Strategic Business Unit(s) (SBUs) operations to be able to proactively analyze and identify opportunities for ... and resolving complex problems and issues. + If supporting Medicare Part D, will be responsible for implementing CMS...focus **Reporting Structure** + Reports to Manager or Sr Director in the Finance department **Responsibilities** + 3+ years… more
- Johns Hopkins University (Baltimore, MD)
- …an **_HIV/AIDS Program Manager_** . Under limited supervision and in collaboration with the Director of the Bartlett Ryan White Service and the Director of ... in applying for health insurance and prescription programs such as ACA, MADAP, Medicare , Medical Assistance, Social Security Extra Help, QMB, and SPDAP. + Refer… more
- CenterWell (Annapolis, MD)
- …and objectively, in consultation with the Human Resources Department and the Executive Director / Director of Operations . + Participates in the interviewing, ... Sign on Bonus! + Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. + Conducts/delegates the assessment and… more
- Humana (Annapolis, MD)
- …in hospice and/or in nursing facilities. They will lead LTSS-ABD care management operations and staff to ensure timely and culturally competent delivery of care ... Oversees staff training, evaluation, and performance monitoring. + Supports the Director /Leadership in meeting the goals of department/market. + Monitors and… more
- Conviva (Annapolis, MD)
- …the clinical education team and will work also closely with Coding operations team and Clinical Excellence team under the CenterWell Primary Care Organization. ... This role reports to Associate Director of coding education and has a dotted line...with the divisional clinical educator and insights from coding operations team and clinical excellence team. The training responsibilities… more
- Huntington Ingalls Industries (Woodlawn, MD)
- …support the Director , Division of Strategic Information (DSI), Center for Medicare and Medicaid Services (CMS) and other government personnel. Day to day ... Our capabilities range from C5ISR, AI and Big Data, cyber operations and synthetic training environments to fleet sustainment, environmental remediation and… more
- Sunrise Senior Living (Silver Spring, MD)
- …Sunrise, our Resident Assessment Coordinator is responsible for all of the facility Medicare and Managed Care residents as directed by the Resident Assessment ... Director . **RESPONSIBILITIES & QUALIFICATIONS** **Responsibilities:** - Ensuring accurate completion...System (PPS) meetings daily and the Triple Check and Medicare meetings weekly - Ensures billing information is available… more