- AmeriHealth Caritas (Newark, DE)
- ** Medical Director , LTSS (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: 34195 **Job Brief** Qualified ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical Directors, Utilization Management and… more
- CVS Health (Hartford, CT)
- …make health care more personal, convenient and affordable. Job Purpose and Summary: The LTSS /SAI National Senior Medical Director , reporting to a Regional ... closely with data analytics team and develops specific actions to manage LTSS related medical cost trends* Develops benchmarks for LTSS clinical staff… more
- Humana (Richmond, VA)
- …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...for the planning, directing, and successful management of the LTSS Clinical Strategy for Department of Medical … more
- CVS Health (Tampa, FL)
- …business strategies are delivered and financial, compliance and quality objectives are met. The LTSS Director will partner closely with the LTSS Executive ... and affordable. Position Summary The Long-Term Services and Support ( LTSS ) Director will partner closely with the...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons is seeking a Director , Long-Term Supports and Services ( LTSS ) Strategy who will oversee day-to-day ... operations of the Medicaid Program Transformation, LTSS program, implementing strategic plans and fostering key relationships with stakeholders. This role will… more
- State of Massachusetts (Boston, MA)
- …Agency (HHA), Independent Nursing (IN), Therapies, DMEPOS programs (Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment, Prosthetics and Orthotics), ... Program of All Inclusive Care for the Elderly (PACE). The Deputy Director Personal Care Attendant Program, Fiscal Intermediary Operations manages the contract for… more
- CVS Health (Hartford, CT)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... physical, behavioral and socioeconomic needs.* Partner closely with the Executive Director of Duals and other Duals Care Management leadership to collaborate… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... person as needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
- Humana (Indianapolis, IN)
- …of our caring community and help us put health first** The Associate Director of Service Coordination leads Managers and teams of Service Coordinators (nurses, ... professionals) responsible for members integrated care planning. The Associate Director requires a solid understanding of how organization capabilities interrelate… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** The Director , Quality & Control Assurance reports to the VP of Quality & Control Assurance is responsible ... Medicare Risk Adjustment, HCC, clinical and coding reviews; DRG and medical records reviews; technology/systems and coding upgrade and implementation reviews (eg… more
- Humana (Muncie, IN)
- …+ Assisting members in maintaining Medicaid eligibility + Collaborate with Medical Director /Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, ... include: + Administer initial and ongoing long-term services and support ( LTSS ) related assessments through person-centered thinking approaches. + Contacts members… more
- Greater Lynn Senior Services (Lynn, MA)
- …scheduled hours of work you may be eligible for: + Hybrid work schedule + Medical and Dental insurance + Health Spending Account + Flexible Spending Accounts (FSA) - ... referral bonuses of up to $1,000 Position Overview: The LTSS Program Clinical Care Nurse will complete program Comprehensive...The NRLP Clinical Care Nurse will support the Program Director in day to day operations of the program.… more
- Centene Corporation (Dover, DE)
- …of plan specific literature and education materials in conjunction with medical director and corporate oversight. **Education/Experience:** Bachelor's or ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Highmark Health (Dover, DE)
- …facilities and providers for care-coordination. + Participate in rounds with the Medical Director . + Review documentation and processes for consistent practice, ... and to promote effective use of resources for members enrolled in DSHP Plus LTSS . Provides direct oversight to Case Managers, meets all of the requirements of a… more