- USAA (Encino, NM)
- …what truly makes us special and impactful. The Opportunity As a dedicated Director , Underwriting Research - Operations, you will be responsible for Managing a team ... of relevant industry practices, trends, and regulatory requirements. Experience reviewing policies and procedures documents and identifying and articulating the… more
- Humana (Santa Fe, NM)
- …work East Coast hours. Please see position requirements for licensing details.** The LTSS Reviewing Medical Director actively uses their medical ... how to operationalize this knowledge into their daily work. The LTSS Reviewing Medical Director 's work includes computer-based review of moderately complex… more
- Humana (Santa Fe, NM)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...clinical standards, and (in some cases) contracts. Primary work reviewing prior-authorization reviews as well as some claims and… more
- Sumitomo Pharma (Santa Fe, NM)
- …. **Job Overview** The ** Director , Medical Strategy ... (Prostate Cancer)** will be a key member of the Medical Affairs team reporting to the Executive Director...**Key Core Competencies** + Strategic thinking, critical analysis and reviewing primary data to develop insights. + Ability to… more
- Curia (Albuquerque, NM)
- …Master Packaging Records, Protocols, Reports, Deviations, CAPAs, and Change Controls. The Director ensures timely disposition of batches by reviewing executed ... Director , Quality Operations, Albuquerque, NM Curia provides global...Assurance, and Client QA. This individual is responsible for reviewing and approving regulated documents and records, such as… more
- Humana (Santa Fe, NM)
- …of our caring community and help us put health first** The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic and ... the development of long-term growth plans and profitability goals The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic… more
- Touro University (Albuquerque, NM)
- Overview Reporting directly to the Director of Clinical Education, the Director of Endodontics at the Touro College of Dental Medicine will have the ... protocols in clinical areas. + Infection Control Compliance + Reviewing student activity as required. + Overseeing Clinical Formative...which includes: + Full range of Health Plans + Medical Plans (choice of EPO, PPO, High Deductible HSA)… more
- Amentum (Santa Fe, NM)
- …than 53,000 employees in approximately 80 countries across all 7 continents. The ** Director of IT SOX Compliance** is responsible for ensuring Amentum IT's SOX ... matrices, etc.), ensuring it is kept current. + Collaborates with the Company's Director of Internal Controls & SOX Compliance to evaluate IT system SOX scoping… more
- Indeed (Albuquerque, NM)
- …(*Comscore, Total Visits, March 2024) **Day to Day** Start the day reviewing executive engagement metrics and prioritizing high-impact opportunities. Meet with the ... to support Indeedians, as well as their pets, kids, and partners including medical , dental, vision, disability and life insurance. Indeedians are able to enroll in… more
- Ryder System (Santa Fe, NM)
- …Responsibilities + Performs other duties as assigned. + Primary backup for the Director assisting as directed with claim assignments, reviewing and tracking all ... claims as well as insurance and contractual coverage issues. Assists Director in the identification of exposures, recommends solutions, promotes loss prevention… more
- Touro University (Albuquerque, NM)
- Overview Directly reporting to the Director of Clinical Education, the Clinical Practice Leader (CPL) at Touro College of Dental Medicine's clinical site in ... to clinical practice. + In the case of community practices, continually reviewing student rosters. + Delegating patient assignments or redistributing to student… more
- Community Health Systems (Las Cruces, NM)
- …Consults with local market leadership as requested (Administrator, Sr. Director Clinics, Director of Clinics, Medical Director , Medical Informatics ... to assess, monitor and improve utilization. This includes, when appropriate, reviewing monthly provider utilization data and working with the Corporate Optimization… more
- Community Health Systems (Roswell, NM)
- …Consults with local market leadership as requested (Administrator, Sr. Director Clinics, Director of Clinics, Medical Director , Medical Informatics ... to assess, monitor and improve utilization. This includes, when appropriate, reviewing monthly provider utilization data and working with the Corporate Optimization… more
- Community Health Systems (Carlsbad, NM)
- …clinical, and outcome information. + Verifies the integrity of data by reviewing records, ensuring consistency with patient charts, and performing routine data ... in the preparation for trauma center re-certification and audits, including reviewing case files, updating records, and providing necessary documentation. + Works… more
- Evolent (Santa Fe, NM)
- …Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . + Appropriately identifies potential ... You Will Be Doing:** The Clinical Letter Writer is responsible for reviewing adverse determination decisions against criteria and policy, escalating questions to the… more
- Rain for Rent (Las Cruces, NM)
- …training and developing the Branch staff ensuring your team's success. + Reviewing all sales and monthly income statements to reduce unnecessary operating costs ... all available personnel options including hiring, training, coaching, mentoring, reviewing , rewarding, disciplining and terminating employees. + Supervise all branch… more
- Community Health Systems (Las Cruces, NM)
- …ensure optimal patient outcomes. This role involves collaborating with interdisciplinary teams, reviewing medical records for appropriateness and medical ... and accreditation standards. **Essential Functions** + Conducts daily reviews of medical records to assess the appropriateness of admission, continued hospital stay,… more
- Cardinal Health (Santa Fe, NM)
- …**_Responsibilities_** + Primary focus will be supporting 3PL Partners within the Medical Segment. + Manages internal Quality Assurance policies and programs to set ... & Drugs Act, Good Manufacturing Practice, and a variety of regulations related to medical devices, natural health products, drugs, and consumer goods. + Leads a team… more
- Molina Healthcare (Las Cruces, NM)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, medical economics/actuaries and local health ... contracting are sufficient to meet requirements. + Responsible for reviewing internal dashboard of Value Based Programs & Contracts...HEDIS and STARS, knowledge of coding + Knowledge of medical economics and financial reporting. Must be able to… more
- Yearout Mechanical LLC (Albuquerque, NM)
- …+ Pre-Qualification & Vendor Support + Assist in gathering and reviewing vendor and subcontractor pre-qualification materials. + Ensure compliance with company ... **Health and Welfare Benefits** + Health and Welfare + Medical + Dental + Vision + Prescription drug +...only be executed by Legence Holdings LLC's CHRO or Director of Talent Acquisition, without exception. All others are… more
