- Elevance Health (Nashville, TN)
- ** 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 (Nashville, TN)
- … 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
- The Cigna Group (Nashville, TN)
- …**Essential Functions and Responsibilities** + Coordinate and partner with the key Medicare operations teams, including claims, enrollment, fulfillment, network ... work with the Provider Data Quality & Accuracy (PDQA) Director to establish the framework and policies to drive...and retain top talent to enable execution of the Medicare growth strategy. **Qualifications** Candidates should model our team's… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Senior Director Regulatory and Accreditation? At HCA Healthcare, you come first. HCA Healthcare has ... have the opportunity to make a difference. We are looking for a dedicated Senior Director Regulatory and Accreditation like you to be a part of our team. **Job… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- GENERAL PURPOSE: The Assistant Director of Rehabilitation is responsible to assist with all but not limited to internal departmental communication and operations ... but is not limited to oversight of the following departmental operations : Compliance with facility's policies, procedures, clinical standards, and protocols.… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a(an) Director Regulatory and Accreditation? At HCA Healthcare, you come first. HCA Healthcare has ... you have the opportunity to make a difference. We are looking for a dedicated Director Regulatory and Accreditation like you to be a part of our team. **Job Summary… more
- Cardinal Health (Nashville, TN)
- …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
- Highmark Health (Nashville, TN)
- …and departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage across footprint. Designs, implements and executes strategies and works ... Organization are met and to optimize outcomes. Collaborates with the company's Medicare Advantage matrixed teams to improve processes, procedures and best practices.… more
- Humana (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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
- Signature Healthcare (Nashville, TN)
- …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,...you Will make a difference + Manage the overall operations of the Nursing Department during absence of a… more
- Signature Healthcare (Clarksville, TN)
- …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 Candidate is very detailed orientated, organized,...you Will make a difference + Manage the overall operations of the Nursing Department in accordance with Company… more
- Vanderbilt University Medical Center (Nashville, TN)
- …**Organization:** VICC - Clinical Trials 40 **Job Summary:** The Assistant Director supervises a team of pre-award financial analysts; analyzes and Evaluates ... Clinical trial budgeting experience * Oncology experience * Understanding of Medicare coverage analysis Department Summary: Vanderbilt-Ingram Cancer Center (VICC) is… more
- LifePoint Health (Gallatin, TN)
- …position will be responsible for management or delegation of day-to-day operations including directing and planning. Formulate and implement operational strategies ... Commission and Conditions of Participation (COP) requirements. Good understanding of Medicare , Medicaid, and other third-party payment systems. Ability to critically… more
- HealthEdge Software Inc (Nashville, TN)
- …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
- Signature Healthcare (Portland, TN)
- …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 ... Healthcare's "Best Places to Work!" How you Will make a difference Our Plant Operations Directors make a difference in the lives of our stakeholders and residents by… more
- Prime Therapeutics (Nashville, TN)
- …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
- Elevance Health (Nashville, TN)
- …+ Ability to analyze and manipulate large and complex datasets. + Background in Medicare operations and/or financial reporting. + Exposure to provider or health ... will you make an impact:** + Partner with Program Director on end-to-end management of retrospective coding program +...risk adjustment and/or health insurance industry. + Experience in Medicare Advantage and Medicaid in a provider based or… more