- 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
- Humana (Trenton, NJ)
- …analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides ... caring community and help us put health first** The Medical Director relies on medical ...or Surgery specialties + Utilization management experience in a medical management review organization, such as Medicare … more
- Humana (Trenton, NJ)
- …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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Trenton, NJ)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- RWJBarnabas Health (Oceanport, NJ)
- …cost reports filings. In partnership with the Vice President of Corporate 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
- Evolent (Trenton, NJ)
- …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...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… 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
- Evolent (Trenton, NJ)
- …Evolent 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...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- CVS Health (Trenton, NJ)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Management staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for… more
- CenterLight Health System (Ridgewood, NY)
- …Under the direction of the Chief Medical Officer, the Regional Medical Director is responsible for the professional, organizational, and administrative ... Medical Practice Oversight: + Serve as the Regional Medical Director for the assigned Diagnostic and...+ Must have a Medicaid Provider ID and a Medicare Provider ID in good standing. Physical Requirements Individuals… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... treatments for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United States, MTPA… 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
- Phoenix House (Long Island City, NY)
- …required regulatory and Healthcare Departments Policies and Procedures. + Works closely with Medical Director , CEO, Director of Residential Services, ... supply and equipment budgets in collaboration with the staff, medical director and CEO. + Develops measures...NYS RN License + NPI Number + Medicaid / Medicare Number (preferred) **REQUIRED EXPERIENCE** + Excellent verbal, written… 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
- New York State Civil Service (Staten Island, NY)
- …HELP No Agency People With Developmental Disabilities, Office for Title Deputy Director DDSO 2 Occupational Category Health Care, Human/Social Services Salary Grade ... innovative leader who can execute strategic decisions to serve as Deputy Director of the Developmental Disabilities State Operations Office in Region 5 (DDSOO… 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
- Mitsubishi Chemical Group (Jersey City, NJ)
- …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... treatments for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United States, MTPA… more