- Humana (Concord, NH)
- …topics to the clinical operations team and healthcare organization. The Medical Director 's work includes computer based review of moderately complex to ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- 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...represents Humana at Administrative Law Judge hearings; exercises independent clinical judgment and decision making on complex issues regarding… 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...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- Molina Healthcare (Madison, WI)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- SUNY Upstate Medical University (Syracuse, NY)
- …and Practice Operations and collaborate closely with Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare ... Job Summary: Position Summary: Upstate University Medical Associates at Syracuse Inc. (UUMAS) is seeking...accurate coding and documentation to support quality initiatives and Medicare compliance. Work closely with clinical teams… more
- Centene Corporation (Queens, NY)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... 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
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims, settlement, claims auditing… more
- Aveanna Healthcare (Pittsburgh, PA)
- Clinical Director - RN ApplyRefer a FriendBack Job Details Requisition #: 207226 Location: Pittsburgh, PA 15233 Category: Nursing Salary: $90,000.00 - $95,000.00 ... of care to our patients. Collaborating closely with area clinical leadership, the Director of Nursing establishes...or without notice. Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Houston Methodist (Katy, TX)
- …areas of Revenue Cycle, to include but not limited to: medical coding, insurance billing, collections, patient account resolution, appeals/denials, customer service, ... HB Epic AR management experience + Strong working knowledge of Facility Medicare (Part A) guidelines. + Problem solving thought leader with proven execution… more
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