- Elevance Health (South Portland, ME)
- ** 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
- First Atlantic Health Care (Saco, ME)
- …Healthcare, part of the Atlantic Heights Community, is a fully-licensed Medicaid/ Medicare -certified facility offering 105 beds. Our Maintenance Team at Seal Rock ... term care, assisted living and senior living. Social Services Director Position Summary As a part of strong care...emotional needs of the resident. + Meet with administration, medical and nursing staff, and other related departments in… more
- Elevance Health (South Portland, ME)
- **Process Improvement Director -HEDIS** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1hour commute from the ... posted Elevance Health locations. This **Process Improvement Director -HEDIS** will be responsible for enterprise HEDIS improvement and governance programs, with… more
- First Atlantic Health Care (Saco, ME)
- …Healthcare, part of the Atlantic Heights Community, is a fully-licensed Medicaid/ Medicare -certified facility offering 105 beds. Our Maintenance Team at Seal Rock ... RESPONSIBILITIES The primary responsibility of this position is to support the Director of Nursing in the administrative operations of the nursing department.… more
- Elevance Health (South Portland, ME)
- …records of denied services for medical necessity + Extrapolates and summarizes medical information for medical director , consultants, and other external ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...+ Conducts investigations and reviews of member and provider medical necessity appeals + Reviews outpatient Medicare … more
- First Atlantic Health Care (Saco, ME)
- …Healthcare, part of the Atlantic Heights Community, is a fully-licensed Medicaid/ Medicare -certified facility offering 105 beds. Our Maintenance Team at Seal Rock ... and policy and procedure implementation. In collaboration with the Director of Nursing, the Quality Manager assists in the...+ Full time employees have access to full benefits; medical , dental, vision, and disability + Employer paid life… more
- Martin's Point Health Care (Portland, ME)
- …prior authorization requests (prior authorization, concurrent review, and retrospective review) for medical necessity referring to Medical Director as needed ... for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees with a need for...regulations, eg Department of Defense, Centers for Medicaid and Medicare , NCQA, Employer contracts and state insurance regulations, as… more
- First Atlantic Health Care (Saco, ME)
- …Healthcare, part of the Atlantic Heights Community, is a fully-licensed Medicaid/ Medicare -certified facility offering 105 beds. Our Maintenance Team at Seal Rock ... grads! LPN Job Summary LPNs work under the direct supervision of the Director of Nursing (DON) and record all resident interactions to develop thorough documentation… more
- First Atlantic Health Care (South Portland, ME)
- …and completion of preliminary paperwork for entering patients. Works with medical , nursing and accounting staff to ensure appropriate patient placement. ... Data entry and communication with insurance companies. + Work with Admissions Director to admit patients to facility, verify insurance eligibility, etc. + Expedites… more