- CVS Health (Louisville, KY)
- … Medicaid Services) requires regulatory changes during the plan year. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** ensures accountability for ... Individual general enrollment, Special Needs Plans (SNP) and Employer Groups. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** acts as the… more
- Molina Healthcare (Louisville, KY)
- …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
- ChenMed (Louisville, KY)
- …We're rapidly expanding and we need great people to join our team. The Director , Network is to be the business and clinical relationships partner to the Regional ... and post-acute providers, and payers in pursuit of improving outcomes and medical cost. Relationship goals include maximizing understanding of the ChenMed care… more
- CommuniCare Health Services Corporate (Corydon, IN)
- Medical Director - Physician Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management ... Indiana, West Virginia, Virginia, Missouri, Pennsylvania and Maryland. As Medical Director , you will be part of...+ Health care management/leadership experience + Familiarity with CMS, Medicare Advantage, SNP Rules and Regulations + HCC and… more
- ChenMed (Louisville, KY)
- …preferred. + Strongly prefer two (2) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
- Elevance Health (Louisville, KY)
- ** Director Behavioral Health Program and Services** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and office). ... depression, and insightful analytics to improve the delivery of care. The ** Director Behavioral Health Program and Services** is responsible for shaping the clinical… more
- Signature Healthcare (Louisville, KY)
- …Plan of Care for each resident in coordination with the physician, Medical Director , nursing staff, and outside consultants (ie, nursing, dietary, ... 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded...Modern Healthcare's "Best Places to Work!" Overview The ideal Director of Nursing Candidate is very detailed orientated, organized,… more
- Signature Healthcare (Radcliff, KY)
- …Plan of Care for each resident in coordination with the physician, Medical Director , nursing staff, and outside consultants (ie, nursing, dietary, ... 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded...Modern Healthcare's "Best Places to Work!" Overview The ideal Director of Nursing Candidate is very detailed orientated, organized,… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... Modern Healthcare's "Best Places to Work!" Overview The ideal Director of Nursing Float Candidate is very detailed orientated,...and Signature Perks include the following and more! + Medical , Dental and Vision - Voluntary Life/Disability + 401(K)… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... and Modern Healthcare's "Best Places to Work!" Overview The ideal Assistant Director of Nursing Candidate is very detailed orientated, organized, great knowledge of… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN/LPN clinical reviewers as well as Support ... appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines, evidence-based medicine,… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... "Best Places to Work!" Overview As the Social Services Director you will identify and provide for each resident's...and Signature Perks include the following and more! + Medical , Dental and Vision - Voluntary Life/Disability + 401(K)… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** A Waystar Regional Director must effectively communicate with target account senior leaders and executives, and coordinate strategy with ... systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... + Minimum of three (3) years experience as a Director of Nursing + Must have previous experience building...and training for our facility leaders + Benefits: 401K, medical , dental, vision and life insurances, free CEUs, discounts… more
- Molina Healthcare (Louisville, KY)
- …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-9, ICD-10… more
- Signature Healthcare (Taylorsville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... exceptional Benefits Package and Signature Perks include the following and more! + Medical , Dental and Vision - Voluntary Life/Disability + 401(K) and Roth 401(K) +… more
- Signature Healthcare (Louisville, KY)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... any action necessary to secure account resolution. + Retrieve Medicare Remittance Advices for all facilities online. Update ...a timely basis, as required and directed by the Director of Accounts Receivable, CFO, the company, and governmental… more
- CenterWell (Clarksville, IN)
- …participant and lead with the care team through daily huddles. . Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of ... Appropriate certification to write prescriptions under the authority of a collaborating physician/ medical director . + This role is considered patient facing and… more
- CenterWell (Louisville, KY)
- … medical expertise with the care team through daily huddles. . Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- ChenMed (Louisville, KY)
- …specific geographic regions. This individual will report to and work with the Network Director to develop the CPL and serve as the local relationship builder with ... for the Center, Specialty, MED COE and HCT leaders to support improved medical costs and specialty care utilization. This individual will work closely with and… more