- Elevance Health (Costa Mesa, CA)
- ** Medical Director - Medicare and Medicaid ** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... required by law. **Candidates must live in California.** The ** Medical Director ** will be responsible for utilization...will be responsible for utilization review case management for Medicare and Medicaid in the California market… more
- ChenMed (Richmond, VA)
- …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
- Robert Half Finance & Accounting (Eatontown, NJ)
- …company located in Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare / Medicaid Reimbursement. + The Director will have ... above. + Planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with...partnership with the Vice President of Corporate Reimbursement, the Director will manage the completion of DSH, Medicare… more
- Humana (Lansing, MI)
- …development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- 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
- 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
- Humana (Olympia, WA)
- …of the managed care industry including Medicare Advantage and Managed Medicaid . + Utilization management experience in a medical management review ... caring community and help us put health first** The Medical Director relies on medical ...organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national… more
- Humana (Little Rock, AR)
- …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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products +… more
- Humana (Raleigh, NC)
- … PLAN AND THE IDEAL CANDIDATE MUST RESIDE IN NORTH CAROLINA. The North Carolina Medicaid Provider Services Director leads a team that is accountable for growing ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- Molina Healthcare (St. Petersburg, FL)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid . This position will provide direct support to the ... UM, Case Management, Claims, and other departments within Molina Medicare and Medicaid regarding A&G operations and... program knowledge. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, high dollar… more