- CVS Health (Jacksonville, FL)
- …deliver solutions to make health care more personal, convenient and affordable. The ** Lead Director ,** ** Medicaid Provider Experience Standardization** ... is responsible for ensuring the variations that currently exist across multiple Medicaid Health plans specific to provider contracting, credentialing, … more
- CVS Health (Jacksonville, FL)
- …and deliver solutions to make health care more personal, convenient and affordable. The Lead Director , Provider Data Governance will develop, enhance, and ... all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (eg, directory listings). Aligns policies… more
- Healthfirst (FL)
- …+ Master's degree or MBA from an accredited institution + Experience in Provider Data Management, Provider Contract, and/or Provider Reimbursement ... Payer or HealthEdge Source platform + Prior experience with claims and provider payment operations in a healthcare payor setting + Experience setting departmental… more
- CVS Health (Tampa, FL)
- …more personal, convenient and affordable. **Position Summary** Aetna is recruiting for a Lead Director , National VBS Development who will develop innovative and ... strategic provider relationships as part of the National VBS Business...strategies across multiple lines of business, including Medicare Advantage, Medicaid , ACA, and Commercial. + Develops relationships with providers… more
- Humana (Tallahassee, FL)
- …as directed. May participate on project teams or organizational committees. Reports to a Lead Medical Director . **Required Qualifications** + MD or DO degree + ... on quality management or utilization management. **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization… more
- Humana (Tallahassee, FL)
- …**Additional Information** Typically reports to a Regional Vice President of Health Services, Lead , or Corporate Medical Director , depending on size of region or ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Tallahassee, FL)
- …**Additional Information** Typically reports to a Regional Vice President of Health Services, Lead , or Corporate Medical Director , depending on size of region or ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- CenterWell (Tallahassee, FL)
- …of our caring community and help us put health first** The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT, ... & HCPCS codes that are submitted to the Centers for Medicare and Medicaid Services (CMS), other payers, and over government agencies. In addition, the Associate … more
- Humana (Tallahassee, FL)
- …requests received by members of the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Brookdale Senior Living (Sarasota, FL)
- …other team members to establish appropriate level of care in accordance with Medicare/ Medicaid reimbursement levels. + Assists the Director , Clinical Services in ... been with us for at least a year. Responsibilities Assists the Director , Clinical Services in planning, organizing, developing and directing the day-to-day… more