- Humana (Columbus, OH)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- CVS Health (Lansing, MI)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... of experience in a Health Care Delivery System eg, Clinical Practice or Health Care Industry * Medical...Board Certified in ABMS Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance &… more
- CVS Health (Lansing, MI)
- …process, drive us to deliver unparalleled results. We are seeking an Executive Director to lead the newly formed **Group Medicare Performance Optimization** ... + Deep engagement with teams such as Finance, Actuarial / Underwriting, Clinical , Network, Medical Economics, Health Care Delivery, Revenue Integrity, Service… more
- The Cigna Group (Bloomfield, CT)
- …Required: Up to 25% - local and some overnight regional travel. The Medicare Advantage Value-Based Contracting Regional Director serves as an integral member ... Advantage Expansion Provider Contracting Team and reports to the Provider Contracting Director . This role is a key contributor to the development of the strategic… more
- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and ... the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional… more
- The Cigna Group (Plano, TX)
- …TEXAS market - can live in Houston, San Antonio, Dallas or Plano** The ** Director , Provider Contracting - Medicare ** serves as an integral member of the ... for service and sophisticated value-based reimbursements with providers for Cigna's Medicare product lines (eg, Hospital systems, Ancillaries, and large physician… more
- The Cigna Group (Bloomfield, CT)
- …a critical position on the NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment. Experience with Medicare Advantage ... This is a ** Medicare Advantage position** WORK LOCATION: REMOTE position The...team currently manages greater than 80 national contracts including clinical programs, MA Supplemental benefits, and direct provider agreements.… more
- CareOregon (Portland, OR)
- Job Title Medical Director - Clinical Services Department Medical Management Administration Exemption Status Exempt Requisition # 24536 Direct Reports ... N/A Manager Title Sr Medical Director - Clinical Services...quality of care for a special needs, dually eligible Medicare population by understanding and applying D-SNP Medicare… more
- Elderwood (Buffalo, NY)
- … of Clinical Reimbursement (RN): + The Director of Clinical Reimbursement ensures adherence to all federal Medicare and Medicaid regulations and ... / Year Overview Elderwood Administrative Services is seeking a highly skilled and experienced Director of Clinical Reimbursement (RN) to lead our clinical … more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary The Senior Director Clinical Programs provides oversight and coordination of care management and ... and will work closely with VP of Health Plan Clinical Program and Director of Health Management...the clinical departments can support enterprise-level growth, clinical outcomes, and medical trend targets. This… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director , and Other ... interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of...internal departments, including but not limited to Health Services, Medical Economics, Sales and Coding in order to develop… more
- Aveanna (York, PA)
- Clinical Director - Registered Nurse ApplyRefer a FriendBack Job Details Requisition #: 197355 Location: York, PA 17402 Category: Clinical Care and Support ... at $90,000.00 per year Position Details Position Overview The Clinical Director is responsible and accountable for...or without notice. Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Henry Ford Health System (Detroit, MI)
- GENERAL SUMMARY: The Medical Director , Central Clinical Trials Office (MDCTO) in the Office of Research Administration (ORA) at Henry Ford Health System ... of HFHS. The MDCTO will work closely with the Director of the Centrial Clinical Trials Office...Research Protections (OHRP), Joint Commission, Centers for Medicaid and Medicare Services (CMS), Association for the Accreditation of Human… more
- UNC Health Care (Chapel Hill, NC)
- …and other staff to ensure appropriate medical staff involvement in clinical management efforts. Assists Director in ensuring the collection, analysis, ... of the unique communities we serve. **Summary:** Responsible for assisting the Director of Transplant Services in overall operations for Ventricular Assist Device,… more
- Aveanna (Fort Wayne, IN)
- Clinical Director - RN - Home Care - $5k sign on bonus! ApplyRefer a FriendBack Job Details Requisition #: 196515 Location: Fort Wayne, IN 46825 Category: ... you when you come to Aveanna. Position Overview The Clinical Director is responsible and accountable for...or without notice. Vaccination Requirements As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Indian Health Service (Fort Duchesne, UT)
- Summary This position serves as the Deputy Clinical Director for Uintah and Ouray Service Unit, located in Fort Duchesne, Utah. The Deputy Clinical ... Director supports the Clinical Director and functions as a member of the Service...The selected individual is required to obtain and maintain medical staff clinical privileges, including any licensure… more
- The Cigna Group (Atlanta, GA)
- …collaborative organization (which includes Market Provider Performance, Sales, Clinical Operations, Stars & Risk Adjustment, Finance , Cross-Segment ... & Solutions). Reporting to the Network Operations Senior Manager or Director , this individual ensures the effective performance management of the provider… more
- The Cigna Group (Maitland, FL)
- …organization (which includes Market Provider Performance, Sales, Health Services, Clinical , Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, ... and Network Development & Solutions). Reporting to the Provider Performance Director , the Provider Performance Manager ensures the effective management of the… more
- ChenMed (Columbus, OH)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... great people to join our team. The Associate Market Clinical Director will directly supervise, performance manage...to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model,… more
- CVS Health (Harrisburg, PA)
- …closely with the LTSS Executive Director , Market CEO, DSNP Senior Leadership Clinical Health Services, Centers for Medicare and Medicaid Services, and State ... to bring accessible healthcare to our members. The LTSS Director , Clinical Health Services ( Director ),...to contract expectations. **Tenure Qualifications** + 5+ years of Medicare DSNP, Medicaid LTSS leadership **Required** + 10+ Years… more