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Nationwide Search for Director of Risk Adjustment Analytics (T-SQL) to oversee the general organization and efficient management of the Medicare Comprehensive Health Assessment Program (CHAPs) data activities for leading healthcare organization. Includes participation in ongoing data mining and analysis, oversight of, development and delivery of education and identification of opportunities to improve reimbursement through proper coding and documentation. Responsible for the ongoing....

- St Louis, MO

Exclusive Search for Finance/Data Analyst with 6+ years complex and high-level financial analysis experience to lead various financial projects. Focus: Cost-effectively manage the utilization of services and develop measures to track, trend and forecast related impacts of organizational strategic initiatives. Run pre-established reports as well as development of new reports for internal stakeholders and regulatory agenciesDevelop metrics to evaluate financial impact of proposed contract....


Exclusive Search for Regional Medical Director to serve as liaison for the health plan. Responsibilities and focus to ensure that all the opportunities are highlighted through detailed reporting to the leadership building creditable and trusting relationships with stakeholders regarding performance metrics and serving as the clinical lead with large employer groups in the bid process. Manage assigned departments or functions with an emphasis on execution, outcomes, continual improvement and....

- St. Louis Area, MO

Exclusive Search for Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit as part of a team of Medical Directors assisting the Chief Medical Director of Fortune 100 healthcare enterprise. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical....


Exclusive Nationwide Search for Senior Medical Director to Assist the Chief Medical Officer (CMO) to direct and coordinate the medical affairs functions for the business enterprise. Oversee the denials and appeals department. May manage other medical directors. Medical Leadership Provide medical leadership for all utilization management, pharmacy, case management, disease management, cost containment, and medical quality improvement activities. Perform medical review activities pertaining to....


Nationwide Search for Director of Risk Adjustment Analytics (T-SQL) to oversee the general organization and efficient management of the Medicare Comprehensive Health Assessment Program (CHAPs) data activities for leading healthcare organization. Includes participation in ongoing data mining and analysis, oversight of, development and delivery of education and identification of opportunities to improve reimbursement through proper coding and documentation. Responsible for the ongoing....


Seeking Director to head up Membership Administration Systems for this healthcare enterprise. A Highly visible role for Healthcare Leader with experience in Operations, Membership Services in the implementation of Healthcare Health Systems and Large scope multi-year project management. Job description Responsible for the management and leadership of a range of process improvement and process management activities. Activities managed include planning, performing, and implementing process....

- Fort Lauderdale, FL

Job descriptionPosition Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective

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