- BlueCross BlueShield of North Carolina (NC)
- …Arrangements (ACO/CIO) and Medicare Quality Initiatives (Stars and Risk Adjustment ). + Excellent presentation, communication and relationship building ... and Blue Shield of North Carolina (Blue Cross NC) is seeking a Medical Director , Medicare Strategy to join our Health Care division. In this dynamic role, you… more
- Molina Healthcare (NY)
- …+ Coordinates accountabilities between segment and markets to drive performance in network, risk adjustment , and stars; single point of contact for escalations ... to mitigate risk and develop/implement improvements across areas that impact Medicare performance. + Collaborates across Medicare segment, with health plans,… more
- Molina Healthcare (Las Cruces, NM)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare ,… more
- Point32Health (Canton, MA)
- …individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD), including submissions to CMS and state ... timely resolution of production issues pertaining to state government and risk adjustment data submissions, including issue investigation, business requirements,… more
- Healthfirst (NY)
- … and Medicaid Services (CMS) practices, policies, and regulations. Expert knowledge of Medicare Risk Adjustment Payment Methodology, HCC, CRG and other ... leadership to analysts and staff in support of all processes related to risk adjustment for Medicaid, Medicare & QHP products. + Direct the communication… more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1)...drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially… more
- Molina Healthcare (Meridian, ID)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance..., and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews… more
- State of Colorado (Denver, CO)
- Clinical Therapist V / Director of Therapeutic Activities - Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4817688) Apply Clinical ... Therapist V / Director of Therapeutic Activities - Denver Salary $2,825.54 - $3,956.31 Biweekly Location Denver, CO Job Type Full Time Job Number IIC-00531… more
- Bristol Myers Squibb (Washington, DC)
- …every treatment we pioneer. Join us and make a difference. **Position Summary** The Director , 340B Policy Strategy, will serve as a deep technical expert in the ... plan for 340B across the BMS Enterprise . The Director will lead 340B strategies that shape public policy...with an acute focus on 340B but including other Medicare / Medicaid programs and key priority policies. +… more
- Molina Healthcare (Louisville, KY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality Program… more