- NHS Management (Prattville, AL)
- …to the facility Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation and MDS/Clinical Information Consultant. ... to the Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation, and MDS/Clinical Information Consultant.… more
- City of Pittsburgh (Pittsburgh, PA)
- …pensions. The Board of Directors is currently in search of an Executive Director . The Executive Director position serves a Board of Directors consisting ... pensions. Reviews monthly check maintenance for accuracy. Assists in processing Medicare Part B inquiries and documentation for applicable retirees. Monitors… more
- Christus Health (Irving, TX)
- …administrative support to the Sr. Reimbursement Analysts and the Regional Director of Reimbursement. Responsibilities: Coordinate and review processes throughout the ... System specific to Medicare cost report software implementation, usage and maintenance for...facilities Timely completion of work is required to ensure Medicare , Medicaid and CHAMPUS cost reports are submitted by… more
- Oak Street Health (Philadelphia, PA)
- …Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care ... candidates may also be considered for a Center Medical Director position. Responsibilities: Assess and diagnose patients at our...be', providing personalized primary care for older adults on Medicare , with the goal of keeping patients healthy and… more
- Christus Health (Santa Fe, NM)
- …calculator Knowledgeable of CPT/ICD-10 coding procedures and familiar with Medicaid, Medicare , and commercial insurance billing procedures Familiar with policies and ... for required experience. NATURE OF SUPERVISION: -Responsible to: CSVCG Service Line Director or designee ENVIRONMENT: Bloodborne pathogen: A - Works in a clean,… more
- Christus Health (Santa Fe, NM)
- …and financial information and check for medical necessity for all Medicare patients. Computer entry, preparing registration paperwork. Send out specimens according ... required; five years preferred. NATURE OF SUPERVISION: -Responsible to: Director , Laboratory ENVIRONMENT: Bloodborne pathogen C (Routine Exposure Risk. Routine… more
- Oak Street Health (West Columbia, SC)
- …Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care ... Highly qualified candidates may also be considered for a Center Medical Director position. Responsibilities: Assess and diagnose patients at our local clinics… more
- Elevance Health (Tampa, FL)
- **Medical Director - Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... must reside in Florida near our Miami or Tampa locations.** The **Medical Director ** will support the following Florida Medicare plans: Simply Healthcare Plans,… more
- CVS Health (Hartford, CT)
- …based (work at home) based anywhere in the US.** **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on ... and Utilization Management Strategy support * Collaborative work with Medicare Quality and Compliance on an ongoing basis *...an ongoing basis * Develop subject matter expertise on Medicare policy for the enterprise * Provide ongoing education… more
- Molina Healthcare (Augusta, GA)
- …clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews quality ... referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing, Pharmacy… more
- Molina Healthcare (Sterling Heights, MI)
- …**Job Summary** Responsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts, ... delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors… more
- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements: The physical requirements described ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and... MAP Advisor- Will promote and sale MAP and Medicare Line of Business, maintains relationships, services our existing… more
- Health Care Service Corporation (Chicago, IL)
- …company that will invest in your professional development. **Job Summary** The Executive Director , Medicare Part D Actuarial will lead the actuarial function for ... Medicare Part D products, including Individual MAPD and PDP,...for product strategy, pricing, and financial performance. The Executive Director provides actuarial leadership across product strategy, benefit design,… more
- UCLA Health (Los Angeles, CA)
- …of our Medicare Advantage products. In this role, you'll partner with the Director of Medicare Product Development and Bids to guide the annual bid process, ... and compliance throughout the member lifecycle. Key Responsibilities: + Lead end-to-end Medicare Advantage product development. + Support and help manage the annual… more
- UCLA Health (Los Angeles, CA)
- Description The Assistant Director , Member Experience will work closely with the Director of Medicare Product Development & Bids to develop, lead, and ... execute the organization's member experience strategy across all Medicare Advantage products. This role is critical to improving CMS Star Ratings by enhancing member… more
- Cleveland Clinic (Cleveland, OH)
- …the Federal Clinical Trials Policy. In this role, you will report to the Director of Research Medicare Coverage Analysis and ensure compliant research billing ... respected healthcare organizations in the world. As a Research Medicare Coverage Analysis Specialist, you will be responsible for...clinical trials for research billing. + Assist the MCA Director on the development of tools and billing grids… more
- CVS Health (Austin, TX)
- …pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise ... Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next...in the United States. In this role as Medical Director MPO (Medical Policy & Operations) you will be… more
- UTMB Health (Galveston, TX)
- …and for directing staff in preparation of these reports. + Supports Director , Finance-Government Reimbursement in preparing annual Medicare , Medicaid and TDCJ ... to implement appropriate processes and procedures to ensure compliance with Medicare and Medicaid regulations. + Supports Director , Finance-Government… more
- NHS Management, LLC (Tuscaloosa, AL)
- …to the facility Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation and MDS/Clinical Information Consultant. ... to the Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation, and MDS/Clinical Information Consultant.… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …and pharmacy), appeals, medical policy (development and maintenance), and quality improvement ( Medicare Stars, NCQA). The Medical Director ensures that Aspirus ... demonstrate those values Every. Single. Day. Aspirus Health Plan is seeking a Director - Medical Director to join our team in Wausau, WI! The Medical Director… more
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