• Behavioral Health Medical Director

    Humana (Helena, MT)
    …The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director ... services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed more
    Humana (11/11/25)
    - Related Jobs
  • Director - Denials Management (Remote)

    Stanford Health Care (Palo Alto, CA)
    …forums to address issues and drive root-cause resolution. + Provides feedback to Managed Care department regarding payor policies and payor contract terms that ... (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** Reporting to the VP,...Overview** Reporting to the VP, Patient Financial Services, the Director , Denials Management serves as the strategic leader and… more
    Stanford Health Care (11/19/25)
    - Related Jobs
  • PCO Medical Director - UM - Full Time

    CenterWell (Boston, MA)
    …the Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an ... community and help us put health first** The Medical Director , Primary Care relies on medical background...as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, … more
    CenterWell (11/06/25)
    - Related Jobs
  • Director Operations, Compliance & Privacy

    UNC Health Care (Morrisville, NC)
    …Health physician groups, Strategy & Corporate Development, Real Estate, Revenue Cycle, Managed Care , UNC School of Medicine, and Research. + Leads people ... of the unique communities we serve. **Summary** : The ** Director of Operations** will report directly to the Chief...relevant laws, regulations, and standards that impact the health care industry. Demonstrated commitment to staying up to date… more
    UNC Health Care (09/28/25)
    - Related Jobs
  • Assistant Director Behavioral Health

    Ventura County (Ventura, CA)
    …through division managers, a comprehensive system of integrated behavioral health services, managed care operations and administrative services; + Assists the ... best practices of behavioral health program planning and administration including managed care operations; recruitment, supervision and personnel management;… more
    Ventura County (11/09/25)
    - Related Jobs
  • Director , Network Contracting

    Point32Health (NH)
    …responsible management experience in a complex healthcare setting. Experience in managed care contracting and experience working collaboratively with providers. ... results and lead teams to achieve goals. + Strong working knowledge of managed care /risk contracting payment methodologies. + Savvy negotiator with experience in… more
    Point32Health (11/06/25)
    - Related Jobs
  • Sr. Associate Director , Employer…

    University of Pennsylvania (Philadelphia, PA)
    …of Relationship Managers and shares responsibility with the other Senior Associate Director for implementing the employer services strategy , including business ... programs and resources, and much more. Posted Job Title Sr. Associate Director , Employer Engagement, Wharton MBA Career Management Job Profile Title Associate … more
    University of Pennsylvania (11/25/25)
    - Related Jobs
  • Director , Utilization Management BH

    Commonwealth Care Alliance (Boston, MA)
    …active RN license required Required Experience: * 7-10 years * 8-10 years of managed care operations experience, including a minimum five (5) years of leadership ... care delivery Required Knowledge, Skills & Abilities: * Medicare and Medicaid managed care experience * Demonstrated knowledge of federal and state… more
    Commonwealth Care Alliance (10/02/25)
    - Related Jobs
  • Operations Management Executive Director

    Sevita (Detroit, MI)
    …state government authorities and referral agencies such as counties, regional centers, managed care contractors, and government administrators. + Advocate on ... adolescents, Military Service Members and Veterans. **Operations Management Executive Director - State of MI** **Compensation: $140,000-$160,000/year with an… more
    Sevita (11/12/25)
    - Related Jobs
  • MCO Director Payment Integrity

    AmeriHealth Caritas (Newtown Square, PA)
    …and insights + At least ten (10) or more years of experience in managed care operations/administration + Working knowledge of CMS guidance and experience with ... **Role Overview** The ** Director of Payment Integrity Solutions** is responsible for...success in triaging, resolving, and optimizing cross-functional processes within managed care organizations + Ability to work… more
    AmeriHealth Caritas (11/21/25)
    - Related Jobs