- Elevance Health (St. Louis, MO)
- …resides within a commutable distance from an office._** The **Business Strategy Plan Director - MedEx ( Medical Expense) Management ** is responsible for ... managing the development and implementation of medical expense management initiatives for assigned Carelon...negotiates for human capital resources, and partners with care management , network, claims & operational teams, IT,… more
- Centene Corporation (Jefferson City, MO)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Medical Express Ambulance Service (Skokie, IL)
- …management of billing and collections operations, ensuring timely, accurate, and compliant claims processing. The Director leads a team of 15 employees, ... About Us: Medical Express Ambulance Service is committed to delivering...professional growth. + Oversee the end-to-end revenue cycle, including claims processing, denial management , account resolution, payment… more
- Dignity Health (Bakersfield, CA)
- … management , remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review ... offices primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. This ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Community Health Systems (Las Cruces, NM)
- The Director of Risk Management is responsible for developing, implementing, and maintaining comprehensive risk management programs to ensure the safety and ... compliance, and promoting a culture of safety throughout the facility. The Director collaborates with hospital leadership, department heads, and legal counsel to… more
- Mount Sinai Health System (New York, NY)
- …and strategic business needs (eg, market sizing), and healthcare topics (eg, claims analysis) with guidance from Quality Director ? Effective communicator ... strong reputation for quality of care (18th ranked academic medical center) and research/education (22nd ranked medical ...transition to a business model focused on population health management - our goal is to keep entire communities… more
- Community Health Systems (Laporte, IN)
- **Job Summary** The ** Director of Risk Management ** provides strategic leadership in developing, implementing, and maintaining the hospital's risk management ... affect patient safety, regulatory compliance, or organizational integrity. The Director collaborates closely with hospital administration, legal counsel, and… more
- UNC Health Care (Morrisville, NC)
- …and Population Health Services Organization. Working closely with UNCHA's Health Informatics Medical Director and the VP for Practice Quality and Innovation, ... management of UNCHA Value Care contracts, Population Management , and UNC Health ambulatory services. The director...in SQL, data warehouse structures, and Epic data sources, claims data sources, claims ingestion, and data… more
- Commonwealth Care Alliance (Boston, MA)
- …provider engagement, delegation partnerships, provider services, contracting, quality, compliance, medical management , and analytics teams to advance provider ... contracting, or network operations, including 3-5 years in a director or senior management role. * Experience...Familiarity with CRM systems (eg, Salesforce) and provider relationship management tools. * Understanding of claims operations,… more