- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management, utilization ... policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice...of 3 years of utilization management experience in a Medicaid , Medicare , dual eligible or commercial health… more
- Advocates (Framingham, MA)
- …that values the ideas and contributions of our staff. The Behavioral Health Regional Medical Director (RMD) is a leadership and clinical role within Advocates' ... Behavioral Health Services Division. The RMD serves as Medical Director for the clinics of an...from the National Practitioner Data Bank and absence of Medicare / Medicaid sanctions. + Currently practicing a minimum… more
- Aveanna Healthcare (Tampa, FL)
- …care to infants, children, adolescents, and/or adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all ... RN Clinical Director ApplyRefer a FriendBack Job Details Requisition #:...Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply… more
- Rush University Medical Center (Chicago, IL)
- …Billing, including payer plans, contracts, and denial workflows . Knowledge of Medicare , Medicaid , and commercial payer regulations related to hospital billing ... **Job Description** **Location:** Chicago, Illinois **Business Unit:** Rush Medical Center **Hospital:** Rush University Medical Center **Department:**… more
- CVS Health (Tallahassee, FL)
- …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... clinical oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare - Medicaid Plan) * Develop and lead clinical strategy and… more
- Elevance Health (Richmond, VA)
- …for ensuring regulatory compliance, operational readiness, and strategic alignment across Medicare - Medicaid integrated products. **How you will make an impact:** ... **Compliance Director - FIDE (Fully Integrated Dual Eligible) Plans**...Medicaid audits preferred. + Prior experience working within Medicare preferred. + Prior experience in supporting Medicaid… more
- Gentiva (Lucasville, OH)
- **Overview** The ** Medical Director ** will report directly to the National Medical Director and supervise, evaluate, and be responsible for the standards ... Experience demonstrated by Hospice & Palliative Medicine board certification, Hospice Medical Director Certification Board certification, or substantial practice… more
- Gilead Sciences, Inc. (Foster City, CA)
- …and legislative developments impacting reimbursement for Gilead's therapies, with a focus on Medicare Advantage, Medicaid , Health Plans, and PBMs. + Develop and ... or 8+ years with an advanced degree (MS, MA, MBA). + Deep knowledge of Medicare and Medicaid reimbursement systems, including Medicaid drug rebate policy, … more
- Aveanna Healthcare (Clark, NJ)
- …any time with or without notice. Vaccination Requirements As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related ... Clinical Director - Home Care - RN ApplyRefer a...or religious reasons as appropriate. As an employer accepting Medicare and Medicaid funds, employees must comply… more
- Ascendis Pharma (Princeton, NJ)
- …Oversee the administration of rebate programs, including government rebates (eg, Medicaid , Medicare ), managed care rebates, and commercial rebates. Ensure ... models, and contracting strategies across various payer segments (eg, commercial, Medicare , Medicaid ). + Excellent negotiation, communication, and interpersonal… more