- ChenMed (Metairie, LA)
- …years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board eligibility is required. + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
- Humana (Lansing, MI)
- …development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- Commonwealth Care Alliance (Boston, MA)
- …have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical ... operations, health care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare ) + Medical Coding, Compliance,… more
- Humana (Concord, NH)
- …sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...care industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations,… more
- Humana (Lansing, MI)
- …of the managed care industry including Medicare Advantage and Managed Medicaid . + Utilization management experience in a medical management review ... caring community and help us put health first** The Medical Director relies on medical ...organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national… more
- Molina Healthcare (Ann Arbor, MI)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid , NCQA and other regulatory requirements....experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Topeka, KS)
- …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… more
- Humana (Honolulu, HI)
- …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 +… more
- Molina Healthcare (Columbus, GA)
- …State Medical License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public ... HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous… more
- State of Colorado (Denver, CO)
- …protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries. + To hold individuals accountable ... of State and Federal regulations; + Work experience with Medicaid or Medicare regulations and statutes; +...cases from intake to completion; + Experience working with medical records and bank records during the course of… more