- VitalCore Health Strategies (Munising, MI)
- …interprets policies, and leads initiatives related to medical services and nursing care . The Regional Medical Director has direct clinical responsibilities and ... in correctional healthcare, has an opening for a Hub Director - Upper Regional Medical Director - Upper Peninsula...leadership, and oversight of all aspects of correctional medical care . This includes, but is not limited to, authorization… more
- Primary Care Solutions (Alamogordo, NM)
- …Your Terms! RESPONSIBILITIES We are seeking a highly skilled and dedicated Medical Director for our Community-Based Outpatient Clinic. In this role, you will have ... will be instrumental in ensuring that our Veterans receive the highest standard of care . At Primary Care Solutions (PCS), we deliver high-quality primary care… more
- Fresenius Medical Center (Waltham, MA)
- **Sr Director Managed Care and Payor Strategy** **PURPOSE AND SCOPE:** The Senior Director of Managed Care & Payor Strategy is a strategic leader ... responsible for driving initiatives that strengthen relationships with Managed Care Payor Organizations and optimize contractual performance. This role leads a… more
- Bristol Myers Squibb (Princeton, NJ)
- …of your application should be directed to Chat with Ripley. R1597489 : Director , Managed Care Rebate Operations **Company:** Bristol-Myers Squibb **Req ... and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data… more
- Huron Consulting Group (Chicago, IL)
- …power of collaboration, Huron offers a rewarding path forward. As the Healthcare Consulting Senior Director - Managed Care & Payment Strategy, you will: + ... design, ACO development (eg, MSSP, ACO REACH, Commercial shared risks), Medicaid managed care participation. Experience with population health initiatives such… more
- St. Luke's Health System (Boise, ID)
- …can be remote from the states of Idaho, Oregon, Utah and Arizona only.** The Director , Managed Care Analytics is responsible for the creation and development ... financial metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for financial performance, identifying areas for… more
- Dignity Health (Bakersfield, CA)
- …shared goals. Responsibilities include: - Collaborate with the Chief Medical Officer, Managed Care and executive leadership to develop, implement, and oversee ... Leadership to ensure consistent physician/APP interactions and experience with all internal Managed Care operations such as enrollment, claims operations and… more
- Fresenius Medical Center (Dallas, TX)
- … programs (HMOs, PPOs, POS, etc). Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate ... financial effect, cost benefit and utilization. + Negotiates contractual relationships with managed care organizations and other third party payors as needed.… more
- Omaha Children's Hospital (Omaha, NE)
- … and Revenue Cycle leadership. **Essential Functions** + Provides analytical support to the Director of Managed Care * Review and project contract ... * Track and monitor payer related issues and communicate to the Director of Managed Care . + Completes month-end balancing, scheduled month-end reports,… more
- Molina Healthcare (AZ)
- …including clinical practice experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality ... of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide… more
- Sedgwick (Helena, MT)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Managed Care Client Service Director (REMOTE) Are you looking for an ... path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs....including two (2) years in a supervisory capacity. **TAKING CARE OF YOU** + Flexible work schedule. + Referral… more
- Molina Healthcare (Chandler, AZ)
- …including clinical practice experience, and at least 2 years as a medical director in managed care organization supporting utilization management/quality ... leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and… more
- Providence (Mission Hills, CA)
- …Answers and screens phones. Schedules and coordinates all meetings attended by Administrative Director of Managed Care , Contract Manager, Case Managers and ... Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters… more
- BlackRock (New York, NY)
- …We are seeking a **Principal Engineer** to join our Platform Engineering Cloud Managed Services team to help us design cloud platforms for mass adoption. The ... (eg containerization, serverless, advanced analytics) that could enhance our managed platform. Drive continuous improvement in deployment processes, reliability… more
- Omaha Children's Hospital (Omaha, NE)
- …and assist with various analysis to understand impact to the organization + Work with Director of Managed Care to aid in understanding of reimbursement ... our mission is to improve the life of every child through exceptional care , advocacy, research and education. As the state's only full-service pediatric healthcare… more
- WellSpan Health (York, PA)
- …root causes of underpayments and denials. + Manages special projects as assigned by the Director of Managed Care . + Seeks and assists with identifying ... performance improvement initiatives within the Payor Contracting department to improve efficiency. + Maintains various contract management systems in collaboration with the Revenue Management and Information Technology departments. **Common Expectations:** +… more
- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must have ... requirements + The unique complex needs of the foster care population + Medicaid Managed Care...+ Perform other secretarial duties as requested by Medical Director . + Any other related duties as required Educational… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will review ... (Medical Director , Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). * Participate in data collection/input into system for… more
- Saint Francis Health System (Tulsa, OK)
- …performs on going analysis, which maintains the integrity of financial expectations of managed care contracts within the Epic system. Resolves programming issues ... other healthcare professionals and staff. Works frequently with individuals at Director level or above. Special Job Dimensions: None. Supplemental Information: This… more
- Huron Consulting Group (Chicago, IL)
- …our team as the expert you are now and create your future. The Huron Managed Services Coding Operations Director oversees a portfolio of clients and is ... Management, Culture, Staff Engagement, Training and Solution Development. The Huron Managed Services Coding Operations Director leads the operations management… more
