• Associate Market Medical Director

    ChenMed (Metairie, LA)
    …years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board eligibility is required. + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
    ChenMed (12/27/25)
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  • Medicare / Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    …have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical ... operations, health care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare ) + Medical Coding, Compliance,… more
    Commonwealth Care Alliance (11/25/25)
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  • Senior Medicaid & Medicare

    OhioHealth (Columbus, OH)
    …**Job Description 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… more
    OhioHealth (12/25/25)
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  • Medical Director - Medicaid

    Humana (Washington, DC)
    …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
    Humana (01/01/26)
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  • Medical Director ( Medicare )

    Molina Healthcare (Augusta, GA)
    …with clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid , NCQA and other regulatory requirements. * Reviews ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ... medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements… more
    Molina Healthcare (01/07/26)
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  • Medicare Sales Field Agent…

    Humana (South Miami, FL)
    …Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare , or both Medicare and Medicaid , achieve their best possible ... under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (01/02/26)
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  • Indiana Medicaid Market CFO

    Humana (Indianapolis, IN)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... part of our caring community and help us put health first** The Indiana Medicaid Market CFO analyzes and forecasts financial, economic, and other data to provide… more
    Humana (11/19/25)
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  • System Manager Revenue Cycle ( Medicare

    Houston Methodist (Katy, TX)
    …Inpatient/ Outpatient Prospective Payment Systems, etc. + Stays informed of the latest Medicare , Medicaid and commercial payor news, updates, and regulations and ... needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash… more
    Houston Methodist (01/10/26)
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  • Medical Director - IP Claims…

    Humana (Raleigh, NC)
    …teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage, and Medicaid requirements and will ... caring community and help us put health first** The Medical Director actively uses their medical...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical more
    Humana (12/11/25)
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  • Medical Director -Payment Integrity

    Humana (Carson City, NV)
    …clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid , and ... caring community and help us put health first** The Medical Director actively uses their medical...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical more
    Humana (12/11/25)
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