- Houston Methodist (Katy, TX)
- …needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash ... Inpatient/ Outpatient Prospective Payment Systems, etc. + Stays informed of the latest Medicare , Medicaid and commercial payor news, updates, and regulations and… more
- RWJBarnabas Health (Oceanport, NJ)
- … will serve as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment strategies ... This includes planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with...with the Vice President of Corporate Reimbursement , the Director will manage the completion of DSH, Medicare… more
- AdventHealth (Altamonte Springs, FL)
- …operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a work ... State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital… more
- Humana (Austin, TX)
- …SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare ...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Baton Rouge, LA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid , or other Medical management organizations, hospitals/ Integrated Delivery ... caring community and help us put health first** The Medical Director actively uses their medical...a medical management review organization, such as Medicare Advantage and managed Medicaid . + Physical… more
- Humana (Raleigh, NC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... caring community and help us put health first** The Medical Director relies on medical ...a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and AVP, the Director will develop long- and short- term Medicare , Medicaid , and other government reimbursement revenue strategies, oversee preparation and ... job, you're making a difference in people's lives.** The Director , Revenue Finance and Reimbursement, will be a core...both government and commercial payment systems; and, (4) Provide Medicare , Medicaid , and payment system expertise in… more
- CVS Health (Springfield, IL)
- …and/or medical necessity appeals for commercial clients, governmental ( Medicare / Medicaid ) programs and individual client requested coverage determinations or ... Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This...decisions. If specifically assigned to one business segment (ie, Medicare clients), each director will become sufficiently… more
- CVS Health (Hartford, CT)
- …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… more
- Molina Healthcare (Layton, UT)
- …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