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The C&S Plan Chief Medical Officer has accountability for ensuring that local health plan, United Clinical Services and UHC initiatives focusing on clinical excellence, quality ratings improvement, appropriate inpatient and outpatient utilization, health care affordability, health system transformation including provider network issues, mandated provisions and compliance, growth and focused improvement are implemented and successfully managed to achieve goals.
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Well known Non-Profit is hiring a Medical Director / Psychiatrist to oversee clinical programming for their Medi-cal managed outpatient programs. This well known and well established agency provides psychiatry, medication management, outpatient substance use treatment, case management, supportive housing, LGBTQ youth and youth care.
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Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. We offer care management programs for asthma, diabetes, and high-risk pregnancy.
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Ability to meet all deadlines, respond promptly and professionally to organizational and clinical issues and manage multiple prioritiesService expansion plans include Transcranial Magnetic Stimulation in Tidal Health's behavioral health outpatient clinic.
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This includes management of a high-performing community-based medical staff and leadership in the areas of clinical quality, risk management, value-based care (managed care), and health center-based medical education programs.
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In conjunction with Clinical Directors, ensures that administrative functions of assigned medical staff are being managed promptly, including chart documentation, required trainings, licensure, and guardianship paperwork.
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We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. + Experience in Utilization Management as a Medical Director within a managed care organization desired.
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In addition, the Behavioral Health Medical Director will assess clinical aspects of specific cases and provide feedback to Care Managers pertaining to best practice standards and quality of care issues.
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The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
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Acts as an advisor and consultant in the establishment of operational policies of the practice to include: (1) Purchasing and capital allocations; (2) Managed care plan participation; (3) Budget and practice expenses; (4) Medicare/Medicaid participation; (5) Billing and collection of professional fees; (6) Personnel management and related policies; (7) Risk management and quality assurance; and (8) Coding compliance.
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Steward Health Care works with Blue Cross Blue Shield of Massachusetts to provide affordable health insurance for our employees in benefit eligible positions. Other Benefits provided: Dental Insurance, Employee Assistance, Transitions Program, 401(k) About Steward Health CareOver a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness.
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As the country's largest physician-led, minority-owned, integrated health care system, our doctors can be certain that we share their interests and those of their patients. The RN is responsible for coordinating care among patient/family, medicine, nursing, ancillary, and other team personnel; acts as patient advocate; and maintains current knowledge and standards of professional nursing practice.
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Experience working in and leading clinical teams in Managed Care, Medicare Advantage, or other value-based reimbursement models. The Medical Director for Senior Care (MD SC) at UCLA Health will be responsible for the establishment and oversight of specialized Senior Care clinics.
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5+ years of medical management and general management experience in a managed care environment is required. The Market Chief Medical Officer is a seasoned professional who faces outward to and interacts with the Plan’s membership and physician community, physician and health system networks, medical/physician professional associations, government representatives, and advocacy groups to advance clinical excellence and the delivery of cost-efficient care.
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PATH regularly achieves the highest levels of accreditation including a 5 Star Provider Rating by CBH, Philadelphias Managed Care Entity, and recognition and awards related to our high-quality, innovative programs and staff accomplishments and contributions.
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behavioral managed care jobs Title: medical in Suwanee, Georgia
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