- Humana (Richmond, VA)
- …Humana Healthy Horizons in Virginia is seeking a Director , Care Management of Long-Term Services and Supports ( LTSS ) who will lead teams of nurses ... and behavior health professionals responsible for care management . The Director , Care Management ( LTSS ) requires an in-depth understanding of how… more
- Humana (Charleston, WV)
- …and help us put health first** Humana Healthy Horizons in Virginia is seeking an Associate Director , Care Management ( LTSS /ABD) who will lead teams of ... providing integrated services for the clinical teams. The Associate Director , Care Management requires a...to identify the clinical tools and systems to support LTSS Care Management activities. **Use… more
- CVS Health (Hartford, CT)
- …national Medicaid LTSS line of business including but not limited to UM, Quality, care management , and network growth as listed below.. * Support the RFP and ... products* Assure compliance with State contracted mandates for cost, quality, and care management initiatives.* Provide clinical expertise and guidance in the… more
- Humana (Annapolis, MD)
- …and help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager, Care Management ( LTSS -ABD) who will lead a team of nurses and ... ( LTSS ) Waiver Services, in hospice and/or in nursing facilities. They will lead LTSS -ABD care management operations and staff to ensure timely and… more
- AmeriHealth Caritas (Newark, DE)
- …of clinical practice. + Experience in Utilization Management as a Medical Director within a managed care organization desired. + Experience with community ... **Medical Director , LTSS (must reside in DE)**...**Responsibilities:** Provides organizational leadership in the operational areas of care management , utilization review, appeals, quality improvement… more
- Centene Corporation (Harrisburg, PA)
- …fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management , quality ... work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous. Experience treating or managing care for a… more
- State of Massachusetts (Boston, MA)
- …care programs, Senior Care Options (SCO) and the Program of All Inclusive Care for the Elderly (PACE). The Deputy Director Personal Care Attendant ... appropriately implement program and ensure access and quality of care . * Ensure program management and service...driving system change. * Knowledge of the Massachusetts health care industry and market dynamics related to LTSS… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Senior Director , Third Party Compliance Oversight reports directly to the SVP, Corporate Compliance & Ethics and Risk ... and leads the Third-Party Compliance Oversight department for Commonwealth Care Alliance (CCA). This position effectively leads our Third-Party Compliance… more
- CVS Health (Hartford, CT)
- …of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing ... Executive Director of Duals and other Duals Care Management leadership to collaborate across the... LTSS highly preferred * 3-5 year of Care Management experience * Ability to work… more
- Commonwealth Care Alliance (Boston, MA)
- …insurance and managed care products and services, including Medicare, Medicaid, MMP, LTSS , SNP, Duals, CHIP, and behavioral health, as well as the associated and ... **Why This Role is Important to Us:** **Position Summary:** The Director , Quality & Control Assurance reports to the VP of Quality & Control Assurance is responsible… more