- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial. The … more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial. The … more
- Molina Healthcare (Las Cruces, NM)
- …leadership based on feedback rom assigned MHI attorney. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting. * ... Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with… more
- LifePoint Health (Los Alamos, NM)
- …and from approximately 8 am to 5 pm. *Your experience matters* Los Alamos Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with ... serve. *How you'll contribute* This position reports to the Director of Quality and manages risk activities and resources...programs such as Leapfrog, CMS, and TJC. * Coordinates medical record review and data abstraction for Core Measures,… more
- Molina Healthcare (NM)
- …and marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction with Director /Manager Provider Contracts, negotiates high priority physician group and ... software. + Targets and recruits additional providers to reduce member access grievances . + Engages targeted contracted providers in renegotiation of rates and/or… more