![MEDSTAR HEALTH](https://media.trabajo.org/img/noimg.jpg)
Director of Medical Policy
4 weeks ago
The Director, Denial Management & Prevention is responsible for directing and administering the programs and activities of a denial prevention and recovery operations. In partnership with the VP Clinical Resource Management, the Director will lead planning and execution of strategic initiatives around technical and clinical/medical necessity denials and appeals across system hospitals.
Collaborates with VP, Clinical Resource Management and other leaders to identify denial mitigation opportunities and reimbursement improvement processes.
Provides strategic direction and clinical oversight for hospital denials and appeal operations and outcomes.
Works with organization leaders to develop performance goals and objectives based on industry best practices and system benchmarks.
Supports system denial mitigation projects and serves as a consultant for individual entities regarding denial trends and interventions.
Works with Acute Case Management teams focusing on operational improvements and team education to support denial reduction.
Collaborates with the Managed Care team to summarize and address payer opportunities.
Works with Corporate Compliance and Rates and Reimbursement team to ensure operations and policies conform to current governmental and state regulations.
Manages business partner/vendor contracts, holding them accountable to contractual obligations and both industry and organizational benchmarks.
Supports the optimization of technology to enhance operational efficiency and improve reimbursement.
Bachelor's degree in Nursing required
5-7 years 5-7 years of Revenue Cycle experience including appeals and financial clearance required and
~ Strong verbal and written communication skills, including presentation skills, with ability to effectively interact with all levels of management, internal departments and external agencies.
Computer skills are required to be efficient in managing data (Word, PowerPoint, Excel and email programs). Advance Microsoft Excel skills.
Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.
-
Director, Assistant Medical
4 weeks ago
Baltimore, MD, United States MEDSTAR HEALTH Full timeThe Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nursing and leadership team. Supports and collaborates with the Director of Nursing in providing leadership and oversight for a specific unit/department. Directs and coordinates the nursing and patient care delivery of the unit-based professional and support personnel....
-
Director, Assistant Medical
4 weeks ago
Baltimore, MD, United States MEDSTAR HEALTH Full timeThe Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nursing and leadership team. Supports and collaborates with the Director of Nursing in providing leadership and oversight for a specific unit/department. Directs and coordinates the nursing and patient care delivery of the unit-based professional and support personnel....
-
Deputy Director of Policy
2 weeks ago
Baltimore, Maryland, United States Vacancies Full timePosition Title:Deputy Director of Policy & Partnership Reports to:Director of Policy and Partnership Department:P&P Department Work Location:Monrovia with frequent travel to Harper (Maryland) Employment Type:Full Time Position Overview:Under the general supervision of the Director of Policy and Partnerships, the position will work across the organization to...
-
Director, Policy
7 days ago
Baltimore, United States Greater Baltimore Committee Full timeJob DescriptionJob DescriptionThe Greater Baltimore Committee (GBC) is the leading voice for the private sector in the Baltimore region, providing insightful economic and civic leadership to drive collective impact. Composed of more than 400 organizations, including large, mid-size, and small companies, nonprofits, foundations, and educational and healthcare...
-
Director, Policy
7 days ago
Baltimore, United States Greater Baltimore Committee Full timeJob DescriptionJob DescriptionThe Greater Baltimore Committee (GBC) is the leading voice for the private sector in the Baltimore region, providing insightful economic and civic leadership to drive collective impact. Composed of more than 400 organizations, including large, mid-size, and small companies, nonprofits, foundations, and educational and healthcare...
-
medical director
2 months ago
Baltimore, Maryland, United States State of Maryland - MDH RICA Baltimore Full timeIntroduction\r GRADEPSYC 0004\r LOCATION OF POSITIONMDH, RICA Baltimore\r605 South Chapel Gate Lane\rBaltimore, MD 2129\r Main Purpose of JobIn\rorder for RICA-Baltimore to function as a family driven, youth guided facility,\rthis position provides the management level of clinical psychiatric services to\rpatients suffering from behavioral health care issues...
-
medical director
4 weeks ago
Baltimore, Maryland, United States State of Maryland - MDH RICA Baltimore Full timeIntroduction\r GRADEPSYC 0004\r LOCATION OF POSITIONMDH, RICA Baltimore\r605 South Chapel Gate Lane\rBaltimore, MD 2129\r Main Purpose of JobIn\rorder for RICA-Baltimore to function as a family driven, youth guided facility,\rthis position provides the management level of clinical psychiatric services to\rpatients suffering from behavioral health care issues...
-
Health Care Workforce Health Policy Analyst
4 weeks ago
Baltimore, United States State of Maryland Full time**Introduction**: **GRADE**: 18 **LOCATION OF POSITION**: MDH - Secretary for Public Health Services 201 W. Preston Street Baltimore, MD 21201 **Main Purpose of Job**: This full-time contractual position reports to the Director of the Office of Population Health Improvement (OPHI) and provides high level policy and legislative support to the OPHI...
-
Health Policy Analyst Advanced
4 weeks ago
Baltimore, United States State of Maryland Full time**Introduction**: **GRADE**: 19 **LOCATION OF POSITION**: MDH - Office of Long Term Services and Supports 201 W. Preston Street Baltimore, MD 21201 **Main Purpose of Job**: The main purpose of this position is to research, develop, and implement high-priority, cross-cutting, and innovative long term services and support policy initiatives for the...
-
Director of Maintenance
3 weeks ago
Baltimore, United States Medical Facilities of America Full timeS eeking a full time Maintenance Director. The successful candidate will have well rounded experience with providing maintenance in a building. Responsibilities of Maintenance Director: Plan, develop, organize, and direct the Maintenance Department. Monitors the performance of maintenance staff by observing staff on all units, on all shifts and...
-
Director of Maintenance
2 weeks ago
Baltimore, Maryland, United States Medical Facilities of America Full timeSeeking a full time Maintenance Director. The successful candidate will have well rounded experience with providing maintenance in a building. Responsibilities of Maintenance Director:Plan, develop, organize, and direct the Maintenance Department. Monitors the performance of maintenance staff by observing staff on all units, on all shifts and interviewing...
-
health policy analyst i
4 weeks ago
Baltimore, Maryland, United States State of Maryland - MDH Med Care Prgms - Ofc of Health Services Full timeIntroduction\r GRADE17\r LOCATION OF POSITIONMDH - Provider Policy & Compliance\r201 W. Preston Street\rBaltimore, MD 21201\r Main Purpose of JobThis full time contractual position will evaluate, analyze, research, and develop provider policies and programs to address high priority projects within Policy and Compliance. To satisfy its responsibilities, this...
-
health policy analyst advanced
4 weeks ago
Baltimore, Maryland, United States State of Maryland - MDH Med Care Prgms - Ofc of Health Services Full timeIntroduction\r GRADE19\r LOCATION OF POSITIONMDH - Office of Long Term Services and Supports\r201 W. Preston Street\rBaltimore, MD 21201�\r Main Purpose of JobThe main purpose of this position is to research, develop, and implement high-priority, cross-cutting, and innovative long term services and support policy initiatives for the Office of Long Term...
-
health policy analyst advanced
2 months ago
Baltimore, Maryland, United States State of Maryland - MDH Med Care Prgms - Ofc of Health Services Full timeIntroduction\r GRADE19\r LOCATION OF POSITIONMDH - Office of Long Term Services and Supports\r201 W. Preston Street\rBaltimore, MD 21201�\r Main Purpose of JobThe main purpose of this position is to research, develop, and implement high-priority, cross-cutting, and innovative long term services and support policy initiatives for the Office of Long Term...
-
Center Medical Director
2 weeks ago
Baltimore, Maryland, United States BALTIMORE MEDICAL SYSTEM, INC. Full timeIf you believe that good medicine has the power to heal our community to its very core, then we invite you to join the Baltimore Medical System (BMS) team, Maryland's largest federally qualified health center. Here, our physicians are dedicated to delivering something different-healthcare with dignity-a model of care that empowers vulnerable and underserved...
-
Senior Director, Finance
4 weeks ago
Baltimore, Maryland, United States University of Maryland Medical System Full timeJob DescriptionThe University of Maryland Medical Center seeks a Senior Director of Finance & Development Operations. As a member of the newly aligned University of Maryland Medicine Philanthropy (UMMP) team, the Senior Director will report directly to the Vice President of Development. With the recent alignment of the advancement initiatives of the...
-
Senior Director, Finance
2 months ago
Baltimore, Maryland, United States University of Maryland Medical System Full timeJob DescriptionThe University of Maryland Medical Center seeks a Senior Director of Finance & Development Operations. As a member of the newly aligned University of Maryland Medicine Philanthropy (UMMP) team, the Senior Director will report directly to the Vice President of Development. With the recent alignment of the advancement initiatives of the...
-
Medical Claims Review, Medical Director
2 weeks ago
Baltimore, Maryland, United States Optum Full timeOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...
-
Center Medical Director
3 months ago
Baltimore, United States Baltimore Medical System Full timeExciting medical leadership opportunity with a vibrant and diverse community health center in the Greater Baltimore area. Our newest facility provides primary care, behavioral health, and OBGYN services to an underserved population. Must have experience supervising physicians, overseeing clinical operations, and providing strategic direction. Must be board...
-
Center Medical Director
5 days ago
Baltimore, United States Baltimore Medical System Full timeExciting medical leadership opportunity with a vibrant and diverse community health center in the Greater Baltimore area. Our newest facility provides primary care, behavioral health, and OBGYN services to an underserved population. Must have experience supervising physicians, overseeing clinical operations, and providing strategic direction. Must be board...