• Executive Director , Reserve Actuary

    CVS Health (Hartford, CT)
    …Supp business actuarial and finance teams. Provide insights regarding the level of medical costs recognized and changes to prior periods. + Oversee the statutory PDR ... and GAAP PDR calculations. + Complete annual gross premium valuations for Medicare Supplement business. + Manage the relationship with the external vendor for… more
    CVS Health (09/04/25)
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  • Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …with all applicable guidelines, regulations and laws established by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services ... that deliver measurable, actionable solutions resulting in improved accuracy of medical record documentation and coding. Promotes the strategy and capabilities to… more
    Highmark Health (08/08/25)
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  • Associate Director , Marketing- Eye Care,…

    AbbVie (Irvine, CA)
    …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... Eye Care Brands across all payer channels (eg Commercial, Medicare , Medicaid, and VA). This individual will be required...that has the potential to affect access to the medical benefit products in Eye Care. + Collaborate cross-functionally… more
    AbbVie (06/23/25)
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  • Center Operations Director

    ChenMed (Cincinnati, OH)
    …to all internal and external customers ( _including patients and other Chen Medical team members_ ). + Monitors office communication and performance to ensure that ... waste and medicine disposal, etc. + Conducts trainings and refreshers regarding Medicare and HIPAA compliance, ensures annual OSHA trainings occur and employees have… more
    ChenMed (08/02/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …Qualifications: 1. Minimum Education/Training Required: Graduate of an accredited medical school. Completion of specialty residency (ie, Internal Medicine, Emergency ... their practical application preferred. Working knowledge of third-party payor guidelines/ medical necessity criteria such as InterQual(R) (ie, knowledge of admission… more
    Catholic Health Services (06/27/25)
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  • Healthy Connections Director of Care…

    Intermountain Health (Murray, UT)
    …more than 1 million members. Select Health's line of businesses include Medicare , Medicaid, FEHB, Marketplace Qualified Health Plans, and fully funded and ... + Supports development and refinement of tools, processes and systems to optimize medical management, clinical outcomes and member satisfaction in order to provide a… more
    Intermountain Health (09/03/25)
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  • Director Of Nursing

    BrightSpring Health Services (Clearwater, FL)
    …with Company policies and procedures, state licensure and regulations, Medicaid and Medicare standards, as well as state reimbursement regulations + Leading case ... nursing and direct care staff, family and/or guardians, and community medical providers and professional consultants in cooperation with operations management +… more
    BrightSpring Health Services (09/02/25)
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  • Director of Nursing / DON

    BrightSpring Health Services (Corpus Christi, TX)
    …with Company policies and procedures, state licensure and regulations, Medicaid and Medicare standards, as well as state reimbursement regulations + Leading case ... nursing and direct care staff, family and/or guardians, and community medical providers and professional consultants in cooperation with operations management +… more
    BrightSpring Health Services (08/29/25)
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  • Director (RN) - Clinical Services

    WellSpan Health (Lebanon, PA)
    …staff by: complying with all applicable safety regulations; learning the impact of medical errors and methodology that will lead to reduction of errors; reporting ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
    WellSpan Health (08/24/25)
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  • Director - Financial Operations (Hospital)

    Trinity Health (Fort Lauderdale, FL)
    …with experience in working in a complex delivery system with a multi-specialty medical group and a Medicare Advantage health plan.** **_Position Highlights and ... Benefits_** + Comprehensive benefit packages available, including medical , dental, vision, paid time off, 403B, and education assistance. + We serve together in the… more
    Trinity Health (08/20/25)
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