- Elevance Health (Wilmington, DE)
- ** 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 (Trenton, NJ)
- … 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
- Aveanna (Allentown, PA)
- Clinical Director - Registered Nurse ApplyRefer a FriendBack Job Details Requisition #: 197281 Location: Allentown, PA 18104 Category: Clinical Care and Support ... Starting at $90,000.00 per year Position Details Position Overview The Clinical Director is responsible and accountable for managing all clinical operations .… more
- Cardinal Health (Trenton, NJ)
- …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
- Penn Medicine (Bala Cynwyd, PA)
- …co-management program (PIC) in partnership with the Department of Psychiatry. The Director is responsible for the operations , performance improvement and ... Hospice- 150 Monument Road** **Hours: Per Departmental Needs** Summary: + The Director , Penn Partners in Care (PPiC) skillfully and strategically leads care… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Director , Broker Digital Sales (Innovation Portfolio Strategy) utilizes ideas, identifies innovation ... opportunities, and translates ideas into actionable and profitable business. The Director , Innovation Portfolio Strategy requires an in-depth understanding of how… more
- Humana (Trenton, NJ)
- …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 (Trenton, NJ)
- …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 (Trenton, NJ)
- …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
- HealthEdge Software Inc (Trenton, NJ)
- …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
- Prime Therapeutics (Trenton, NJ)
- …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
- ChenMed (Philadelphia, PA)
- …mastery of: * PCP Black Belt Training and PCP Essentials * Medical Director Essentials and Center Operations * Medical Economics and Center Financial ... organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a...our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director… more
- RWJBarnabas Health (Hamilton, NJ)
- …The RN Clinical Care Coordinator is a critical component of the value-based operations care management team. The RN Clinical Care Coordinator will oversee the ... in an acute care setting and after discharge. For Medicare patients enrolled in Comprehensive Joint Replacement (CJR) lives,...facility, if applicable + Engagement with the Care Management Director and Physician Advisors + Identify units with the… more
- Genesis Healthcare (Philadelphia, PA)
- … operations through training classes. *Participate in nursing centers' Medicare meetings to review coverage and documentation issues and requirements. Report ... maximize revenue through the evaluation and optimization of the Medicare /Medicaid reimbursement process. Position Highlights*Participate in the development, implementation,… more
- Virtua Health (Voorhees, NJ)
- …hour accountability and day-to-day oversight and supervision to ensure optimal operations , safety, highly functional business systems and quality patient care; ... development and implementation of policies and procedures that govern the operations of the practices/clinics and follows established policies and procedures,… more
- Conviva (Trenton, NJ)
- …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
- Gentiva (Blue Bell, PA)
- …Hospice Case Management experience.** You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible for ... the day to day operations of your assigned hospice site, administering the clinical...Managing the site in the absence of the Executive Director , Administrator, or Senior/Executive Patient Care Manager. + Managing… more
- Penn Medicine (Berwyn, PA)
- …agencies and professional accrediting agencies' regulatory requirements impacting lab operations including: AABB, CMS (Center for Medicare /Medicaid Services), ... noted are corrected. + **Fiscal Management** : Works with Administrative Director or Technical Manager to coordinate and collate department(s) annual capital,… more
- WTW (Philadelphia, PA)
- …Finance Business Partner, you will be responsible for supporting Business and Operations Leaders with the execution of finance tasks; namely reporting, planning and ... ownership for P&L management (revenue, expense, profitability) + Support Segment Finance Director with management of key risks and opportunities within the business… more
- Virtua Health (Voorhees, NJ)
- …not limited to assisting and providing necessary support to the GME Manager and Director on the day-to-day operations of the GME department. Provide education, ... the Program Directors, Residents and support staff with the day-to day operations of the Residency Training Programs. Maintain all accreditation statuses by adhering… more