- AmeriHealth Caritas (Detroit, MI)
- …and authorizations, including home- and community-based programs. + Collaborate with the Medical Director and care team to develop and monitor treatment ... the Medicare LTSS Care Coordinator manages care coordination for Medicare beneficiaries with complex medical , behavioral health, Long-Term Services &… more
- Houston Methodist (Katy, TX)
- …areas of Revenue Cycle, to include but not limited to: medical coding, insurance billing, collections, patient account resolution, appeals/denials, customer service, ... procedures, and provides quality reviews. Reports results of key performance metrics to director on a timely basis. **FINANCE ESSENTIAL FUNCTIONS** + Assists in the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for… more
- CenterWell (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Jefferson City, MO)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- CenterWell (Las Vegas, NV)
- …the lives of our patients, and the healthcare industry as a whole. The Associate Medical Director serves as a health-care professional and capable of handling a ... variety of health-related problems. The Associate Medical Director requires a solid understanding of...**Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- CVS Health (Des Moines, IA)
- …and behavioral health programs and services to its membership. Aetna is looking for a medical director to be part of a centralized team that supports the ... related to precertification, concurrent review, and appeal request. The medical director is a work-at-home position located...Two (2) + years of experience in managed care ( Medicare and/or Medicaid) MD or DO; Board certification in… more
- AdventHealth (Altamonte Springs, FL)
- …impacts of proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for ... and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital… more