- Robert Half Finance & Accounting (Eatontown, NJ)
- …located in Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare /Medicaid Reimbursement. + The Director will have advanced level ... to support employees + Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Life & Accidental...partnership with the Vice President of Corporate Reimbursement, the Director will manage the completion of DSH, Medicare… more
- Humana (Little Rock, AR)
- …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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- CVS Health (Chicago, IL)
- …heart, each and every day. **Position Summary** Aetna is recruiting for a Lead Director , Actuarial - Medicare who will be responsible for understanding and ... driving action on Medicare Network Insights and curating support for this important...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Molina Healthcare (Des Moines, IA)
- …Summary** Responsible for leading, organizing and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with ... the standards and requirements established by the Centers for Medicare and Medicaid. **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of… more
- Molina Healthcare (St. Petersburg, FL)
- …Summary** Responsible for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible for reviewing and ... accordance with the standards and requirements established by the Centers for Medicare and Medicaid. This position will provide direct support to the implementation… more
- CVS Health (Boston, MA)
- …We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal ... candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a strong… more
- University of Miami (Miami, FL)
- …when necessary + Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population ... evaluations. This role also works directly with staff, administration, medical directors, and other relevant stakeholders to assure appropriate...preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of… more
- SUNY Upstate Medical University (Syracuse, NY)
- …and Practice Operations and collaborate closely with Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare ... Job Summary: Position Summary: Upstate University Medical Associates at Syracuse Inc. (UUMAS) is seeking...or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… more
- Centene Corporation (Queens, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is...position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as… more