- Humana (Montpelier, VT)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis analyzes and forecasts financial, economic, and other data ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Humana (Lansing, MI)
- …diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors ... Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care… more
- CVS Health (Oklahoma City, OK)
- …their clinical quality and effective use of health care resources. **This is a remote -based (work from home) role.** In this role as Medical Director (Behavioral ... Health), you will: * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical necessity decisions * Provide comprehensive behavioral health care management to facilitate… more
- RWJBarnabas Health (Oceanport, NJ)
- Director , Corporate Reimbursement (Hybrid/ Remote ) - Oceanport, NJReq #:0000180233 Category:Professional / Management Status:Full-Time Shift:Day ... $209,501.00 per year Location: Oceanport, Oceanport, NJ 07052 Job Title: Director Location: Barnabas Health Corp Department: Corporate Reimbursement Req#: 0000180233… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr....Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports… more
- Centene Corporation (Salem, OR)
- …benefits including a fresh perspective on workplace flexibility. **We're Hiring: Remote Child Behavioral Medical Directors** Centene Corporation is a leading ... government-sponsored healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and… more
- Evolent (Dover, DE)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology to ... innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple opportunities for a… more
- Molina Healthcare (Davenport, IA)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Program Director is a key Quality Improvement (QI) leader within the ... needs. + Manages QI programs with oversight from the Director , AVP and VP as needed. + Collaborates and...of and experience with HEDIS programs. + 2 years Medicaid experience + 2 years Medicare experience + 3… more
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