- Humana (Concord, NH)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Olympia, WA)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Elevance Health (Richmond, VA)
- ** Medical Director - Medicare Fee for Service** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... and Medicaid Services to transform federal health programs. The ** Medical Director ** is responsible for drafting and...as needed with review of claims. Works with other Medicare Administrative Contractor (MAC) Medical Directors for… more
- CVS Health (Hartford, CT)
- …the US. Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part C appeals (both provider and ... * Board Certified in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience. *… more
- Humana (Frankfort, KY)
- **Become 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 (Little Rock, AR)
- **Become 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
- CVS Health (Boston, MA)
- …actuarial analytics and pricing. The ideal candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing ... Key Responsibilities: + Lead the development and execution of actuarial analytics strategies for Medicare Advantage and Part D programs. + Inform and enhance the… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... belief system.** We believe wellness and sickness are both part of a lifelong partnership, and that everyone could...This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities.… more
- Centene Corporation (Queens, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is...position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as… more
- Community Health Systems (Palmer, AK)
- …Information Management, or related field preferred + 1-2 years of experience in Medicare billing, medical claims processing, or hospital revenue cycle operations ... As a ** Medicare Billing Specialist** at **Susitna Surgery Center** you'll join a team and be a part of a culture that's dedicated to providing top quality care… more