- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral ... health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the… 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 ... insightful analytics to improve the delivery of care. The ** Director Behavioral Health Program and...care. + Supports cost management projects through analysis of medical expense to determine savings for both proposed and… more
- Centene Corporation (Frankfort, KY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Elevance Health (Louisville, KY)
- …delivered high-impact results for over 150 years. With capabilities spanning pharmacy, behavioral health , complex care delivery, medical benefits management, ... teams involved in Utilization Management, Specialty Benefits Management, Payment Integrity, Advocacy, Health Plan Subrogation, Behavioral Health , Health … more
- Highmark Health (Frankfort, KY)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Highmark Health (Frankfort, KY)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This role leads a Pharmacology & Therapeutics Committee and serves as a Medication ... requested. . **Q** **UALIFICATIONS:** **Required** + Doctorate degree in Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- ChenMed (Louisville, KY)
- …specialists, hospital providers, and post-acute providers, including skilled nursing facilities, home health , behavioral health , social service, and other ... we need great people to join our team. The Director , Network is to be the business and clinical...providers, and payers in pursuit of improving outcomes and medical cost. Relationship goals include maximizing understanding of the… more
- BrightSpring Health Services (Louisville, KY)
- …including pharmacy, home health care and primary care, and rehabilitation and behavioral health , we provide comprehensive care and clinical solutions in all ... Our Company BrightSpring Health Services Overview Director of Clinical...appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines, evidence-based… more
- Highmark Health (Frankfort, KY)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** Highmark seeks a Director of Rating Tools Enablement to lead the design, development, and ... Oversee the execution of analytics to support the implementation of key medical cost savings initiatives: Understand the insights required to capture cost-savings,… more
- HCA Healthcare (Louisville, KY)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... lives of many. Jump-start your career as a Senior Director of Accreditation - Compliance - RA today with...needs are met. We offer a comprehensive package of medical , dental, and vision plans along with unique benefits,… more
- HCA Healthcare (Louisville, KY)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... the lives of many. Jump-start your career as a Director of Accreditation today with Galen College of Nursing....needs are met. We offer a comprehensive package of medical , dental, and vision plans along with unique benefits,… more
- ChenMed (Louisville, KY)
- …5 years preferred. + Strongly prefer two (2) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population ... activities preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to… more
- Highmark Health (Frankfort, KY)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- Highmark Health (Frankfort, KY)
- …initiatives. These functions collectively maintain the Organization's reimbursements to all health care providers, and serve as a consulting resource in maintaining ... in reimbursement and payment model design + Familiarity with core health plan reimbursement operations **_Preferred_** + Familiarity with alternative care model… more
- NASCO (Frankfort, KY)
- …Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell options + 9 Company ... **Overview** As Executive Director , Compliance you will lead and provide oversight...is designed to support the physical, mental, and financial health of our associates. We offer: **Physical and Mental… more
- Merck (Frankfort, KY)
- **Job Description** The Clinical Research Director (CRD) is the Clinical Operations lead in a country/cluster and is responsible for execution of all Clinical Trials ... Research & Development Division / GCD Therapy Areas, and when appropriate Human Health . + Working with regional and global colleagues develops and executes the GCTO… more
- CenterWell (Frankfort, KY)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- Magellan Health Services (Fort Knox, KY)
- …with parents, personnel, schools, and consultation to installation command regarding behavioral health issues affecting children and youth. CYB School ... - Required Clinical Work Experience - Preferred Education - Required Master's - Behavioral Health , Master's - Social Work Education - Preferred License and… more
- HCA Healthcare (Frankfort, KY)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...problem or immediately notify the coordinator, laboratory management or medical director . + You will document all… more
- HCA Healthcare (Frankfort, KY)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... and the United Kingdom. We are looking for a Medical Surgical Nurse Manager for our Frankfort Regional ...Center offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more