- NHS Management (Prattville, AL)
- …to the facility Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation and MDS/Clinical Information Consultant. ... to the Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation, and MDS/Clinical Information Consultant.… more
- Unknown (Albuquerque, NM)
- …and a deep understanding of compliance requirements, particularly in the areas of Medicare and Medicaid, are essential. The Executive Director will also be ... Executive Director , Nonprofit Operations & Family Services About the...The Company is in search of a dedicated Executive Director to lead its mission of providing comfort, care,… more
- Elevance Health (Tampa, FL)
- **Medical Director - Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... must reside in Florida near our Miami or Tampa locations.** The **Medical Director ** will support the following Florida Medicare plans: Simply Healthcare Plans,… more
- CVS Health (Hartford, CT)
- …based (work at home) based anywhere in the US.** **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on ... and Utilization Management Strategy support * Collaborative work with Medicare Quality and Compliance on an ongoing basis *...an ongoing basis * Develop subject matter expertise on Medicare policy for the enterprise * Provide ongoing education… more
- Molina Healthcare (Augusta, GA)
- …clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews quality ... referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing, Pharmacy… more
- Molina Healthcare (Sterling Heights, MI)
- …**Job Summary** Responsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts, ... delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors… more
- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements: The physical requirements described ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and... MAP Advisor- Will promote and sale MAP and Medicare Line of Business, maintains relationships, services our existing… more
- Health Care Service Corporation (Chicago, IL)
- …company that will invest in your professional development. **Job Summary** The Executive Director , Medicare Part D Actuarial will lead the actuarial function for ... Medicare Part D products, including Individual MAPD and PDP,...for product strategy, pricing, and financial performance. The Executive Director provides actuarial leadership across product strategy, benefit design,… more
- UCLA Health (Los Angeles, CA)
- …of our Medicare Advantage products. In this role, you'll partner with the Director of Medicare Product Development and Bids to guide the annual bid process, ... and compliance throughout the member lifecycle. Key Responsibilities: + Lead end-to-end Medicare Advantage product development. + Support and help manage the annual… more
- Henry Ford Health System (Troy, MI)
- …Officer AVP, Population Health Management AVP, Quality Improvement and Management Senior Director Medicare Stars, HEDIS, and Reporting HAP Medical Directors Vice ... The HAP Medical Director represents the plan and its interests in...Presidents within Pharmacy, Strategic Development, Provider Relations Vice President, Medicare /MMP Operations Various HFHS Executives/Clinical Leaders and non-HFHS network… more
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