- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review 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 passionate… more
- Humana (Washington, DC)
- …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
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... for all of Sharp Health Plan products, (Commercial, Exchange, Medicare , POS/PPO) services, and oversees the health care needs...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has overall accountability for ... of the Quality Management/Utilization Management (QM/UM) Plan, including having the BH Medical Director for Children's Services and participate on the BH… more
- Molina Healthcare (Salt Lake City, UT)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care....experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Pine Acres Rehabilitation & Care Center (Nebraska City, NE)
- …Services Director will assist residents in voicing and obtaining resolution to grievances . The Director will review complaints and grievances made by ... SOCIAL SERVICES/ADMISSIONS DIRECTOR JOB DESCRIPTION Department Social Services Reports to...actions and interactions are adequately documented in each resident's medical record, and that legal, ethical, and professional standards… more
- Somatus (Mclean, VA)
- …provides guidance and oversight to all lines of business including Commercial, Medicaid, Medicare , and Special Need Plans (SNPs). The Director , Quality will work ... the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Dental Director is responsible for providing clinical oversight to promote the oral health of the ... appeals, and potential quality of care issues. The Dental Director - Texas assists in the design, development, and...professional standards o Review and resolve provider and member grievances and appeals o Provide and advance the clinical… more
- State of Colorado (Grand Junction, CO)
- Behavioral Site Director (Health Professional V) - Grand Junction Regional Center (WESTERN SLOPE) Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5049612) Apply Behavioral Site Director (Health Professional V) - Grand Junction Regional Center… more
- HCA Healthcare (Richmond, VA)
- …**Introduction** Are you ready to manage in a new era as a Executive Director of Behavioral Health Programs where building a healthier tomorrow is more than a ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...HCA Healthcare facility. Be an impact as a(an) Executive Director of Behavioral Health Programs where your passion for… more
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