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director of clinical care services

director of physicians billing office customer service

UCLA Health

<div><div>Description
The Director of Physicians&rsquo; Billing Office (PBO) Customer Service provides leadership and operational oversight for customer service, guarantor billing, collections, and credit and refund. This role ensures efficient, accurate, and patient-focused billing operations while driving strong financial performance, regulatory compliance, and service excellence.
The position partners with leadership, clinical departments, information technology teams, vendors, and Faculty Practice Group divisions to improve workflows, enhance systems, manage risk, and deliver consistent customer service standards. The Director is accountable for operational outcomes, staff performance, and continuous improvement across assigned units.
Key Responsibilities<ul><li>
Lead daily operations for customer service, guarantor billing, collections, bad debt, and credit and refund processes.</li><li>
Establish service standards, policies, and procedures to ensure timely, accurate, and professional patient support.</li><li>
Manage managers and supervisors through coaching, performance management, staffing, and employee development.</li><li>
Review operational data, call center metrics, and audit results to identify risks and improve performance.</li><li>
Resolve complex billing issues, account escalations, payment discrepancies, and service concerns.</li><li>
Partner with hospital, physician group, and internal stakeholders to enhance patient financial experience.</li><li>
Oversee vendor relationships, outsourced services, and call center technology performance.</li><li>
Collaborate with IT teams on system enhancements, workflow integration, and data accuracy improvements.</li><li>
Provide dashboards, reports, and trend analyses to leadership to support decision-making.</li><li>
Ensure compliance with payer requirements, regulatory standards, PCI controls, and internal policies.</li><li>
Lead continuous improvement initiatives that increase efficiency, quality, collections, and patient satisfaction.</li></ul><div>
Salary Range: $116,300 - $264,600/annually</div></div><div>
Qualifications
Required:<ul><li>
Bachelor&rsquo;s degree in a related field or equivalent combination of education and experience</li><li>
Minimum 10 ot more years of progressive experience in patient billing, collections, or revenue cycle management</li><li>
Applies advanced knowledge of medical billing, reimbursement methodologies, and payer regulations, including Medicare and Medi-Cal</li><li>
Utilizes strong analytical skills to evaluate operational trends, financial outcomes, and performance metrics</li><li>
Exercises sound judgment when resolving complex billing, compliance, or operational issues</li><li>
Communicates clearly and effectively with physicians, patients, payers, vendors, and leadership</li><li>
Leads development and implementation of operational policies, procedures, and internal controls</li><li>
Manages large, multi-layered teams while balancing competing operational priorities</li><li>
Maintains thorough knowledge of revenue cycle systems and customer service platforms</li><li>
Builds collaborative partnerships across clinical, technical, and administrative functions</li><li>
Demonstrates proficiency with reporting tools and common business software, including Microsoft Excel</li><li>
Maintains confidentiality when handling sensitive patient, financial, or organizational information</li></ul></div></div><div></div>

Director of Physicians’ Billing Office Customer Service

Intercare Therapy

About Intercare Therapy
 
Intercare Therapy, Inc. (ICT) provides evidence-based behavior therapy services that support individuals with autism and related disorders and their families. Our mission is to optimize the independence and quality of life of our clients and their families. We are committed to evidence-based practices, excellent customer service, and employee quality of professional experience. We strive to be the preferred service provider and referral partner to our funding sources as well as the employer of choice for behavior analysts in search of a long-term professional home.
 
About the Role
 
The Authorizations Coordinator is a vital member of our Intake and Admissions team, ensuring that client families receive timely treatment authorizations from their funding sources. In this role, you will build strong relationships with funding sources, drive the efficient approval of authorizations, and continuously look for ways to improve the process. This position reports to the Senior Manager, Intake and Admissions.
 
The Authorizations Coordinator reports to the Senior Manager, Intake and Admissions.
 
Hourly Rate: $22 - $24
 Location: Remote
 
Job Type: Full-Time
 
What We Offer
 
<ul>
<li>Comprehensive medical, dental, and vision insurance</li>
<li>401(k) retirement plan</li>
<li>Paid time off and paid holidays</li>
<li>Fully remote work environment</li>
<li>Collaborative, supportive team culture</li>
<li>Meaningful work that directly impacts children and families living with autism</li>
<li>Opportunities for professional growth within a growing organization</li>
</ul>
What You’ll Do
 
Authorization Management
 
<ul>
<li>Request initial and reauthorizations from funding sources, submit supporting assessment reports, and follow up to track and document approval status through to completion</li>
<li>Enter authorizations into Central Reach and task the Caseload Planner for client launch</li>
<li>Distribute completed assessment reports to client families upon funding source approval</li>
<li>Track authorization expiration dates and proactively coordinate with the Clinical team to ensure renewals are completed without service interruption</li>
<li>Oversee the interim authorization process, ensuring continuity of care during coverage transitions</li>
</ul>
Billing & Compliance
 
<ul>
<li>Partner with Billing to resolve invoice rejections from insurance plans</li>
<li>Collaborate with Contracting on billing issues or escalations</li>
<li>Conduct regular billing audits for key funding sources</li>
</ul>
Communication & Coordination
 
<ul>
<li>Coordinate communications between the Clinical team and funding sources as needed</li>
<li>Cross-train and collaborate with the Intake and Admissions team to provide seamless coverage and support</li>
</ul>
What You’ll Bring
 
<ul>
<li>Minimum 3 years of administrative and/or customer service experience</li>
<li>Minimum 2 years of experience with commercial insurance (required; ABA or behavioral health experience a strong plus)</li>
<li>Familiarity with ICD/CPT codes or medical billing terminology preferred</li>
<li>Experience with Central Reach or similar practice management/EHR software</li>
<li>Experience with Salesforce or similar CRM platform</li>
<li>Proficiency with Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)</li>
<li>Exceptional organizational skills — able to manage many moving pieces without letting details slip</li>
<li>Strong written and verbal communication skills; professional and courteous in all interactions</li>
<li>Ability to collaborate effectively across clinical, billing, and administrative teams</li>
<li>Strong data organization skills — able to compile information from multiple sources and communicate findings clearly to leadership and cross-functional teams</li>
<li>A genuine passion for helping families access autism therapy services</li>
<li>Bilingual English/Spanish a plus, but not required</li>
</ul>
Education
 
<ul>
<li>High school diploma or GED required</li>
<li>Associate’s or Bachelor’s degree in a related field preferred, but not required with equivalent experience</li>
</ul>
Intercare Therapy, Inc. is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees regardless of race, color, religion, sex, national origin, disability, or veteran status.

Authorizations Coordinator

Keck Medicine of USC

<div>As a part of the Ambulatory clinic, provide smooth outpatient flow resulting in optimum patient satisfaction and clinic operation. Excellent interpersonal and communication skills to coordinate multiple appointments with many multi-specialty clinical services. Participate in a variety of duties associated with daily clinic preparation process, from customer service, message distribution, procedure scheduling, encounter registration, and referrals management.
Must be highly flexible, enthusiastic, have a proactive approach, work efficiently under pressure and work efficiently in a team environment. Must be comfortable with computers and medical terminology. In depth knowledge of major insurance plans and types of coverage provided, including government health programs.
Essential Duties
<ul><li>Clerical &bull; Has thorough understanding and expertise in the use of computer systems, e.g. Cerner and GE Centricity Business. Demonstrates accuracy and thoroughness in entering information into computer systems. &bull; Processes new referrals in a timely manner; this includes obtaining required outside medical records, entering demographic information into computer system, providing medical records to physician I multidisciplinary team for review, verifying insurance and obtaining authorization for visits and procedures. &bull; Schedules patient's evaluation and clinic appointments in a timely manner, and at the request of the physician, while accommodating patient's needs. This includes but not limited to: laboratories, diagnostic testing and consultations as needed. Fulfills other department scheduling functions per department procedures and protocols. &bull; Proactively manages clinic schedules, including reviewing master schedule and anticipating requirements and changes based on activity levels to create a well-managed operational flow and positive patient experience. &bull; Coordinates scheduling of diagnostic testing for patients which include but not limited to sending letters of medical necessity. &bull; Assists in clinic with clerical and scheduling needs including filing and collection of supporting documentation for billing. &bull; Provides phone coverage as needed. Contacts and distributes messages to medical personnel using a variety of electronic messages including text, voice, and email systems. Reads and responds to email throughout the day. Retrieves and responds to voicemail messages within 24hours per department protocol.
</li><li>Patient Customer Service &bull; Utilizes Courtesy, compassion, kindness and honesty while interacting with public, patients, and all clinic personnel. Greets patients in a courteous and professional manner. &bull; Acts as a single point of contact for patient and caregivers, and takes accountability for their patient experience. Provides information and guidance to patients and caregivers regarding all areas of patient care. This includes but not limited to: scheduling, paperwork, and follow up appointments. &bull; Work independently under limited supervision, takes initiative, deals effectively with constant change and willingly accepts responsibility. &bull; Completes a financial risk assessment and as indicated, provides assistance to patient/patient families regarding insurance benefits and alternative funding sources, including referral of complex financial or insurance coverage issues to financial counselors or others such as designated admitting representative. &bull; Provides estimate of patient liabilities to patients, physician and insurance companies based on guidelines and/or systems provided by the department, including but not limited to: copayment, deductibles, co-insurance, deposits, or prior account balances. &bull; Facilitates communication between patient and caregivers, and all members of the care team, including physicians, nurses, lab, etc. Communicates all changes with patient and case information to all involved personnel. Works with various hospital personnel to resolve issues and accommodate patient. &bull; Adheres to policies aimed to protect patient confidentiality.
</li><li>Clinical &bull; Prepares patients for examinations. Obtains and records vital signs. &bull; Assists the physician with exams and procedures. &bull; Ensures that physician orders for medications and treatments are implemented by the appropriate staff. &bull; Records patient information in chart/EHR. &bull; Determines patient care needs and directs patients accordingly.
</li><li>Performs other duties as assigned.
</li><li>Teamwork/Collaboration &bull; Demonstrates flexibility in covering other staff members for sick time, vacation, or leave of absence. &bull; Possesses ability to work independently and in a team setting. &bull; Maintains an open line of communication with management and other staff and demonstrates a professional demeanor at all times. &bull; Is involved with and keeps abreast of changes within the USC healthcare system.
</li><li>Performs other related duties as assigned.
</li></ul>Required Qualifications:
<ul><li>Req High school or equivalent
</li></ul><ul><li>Equivalent work experience in customer service and/or medical office.
</li></ul><ul><li>Req Proven record of dealing with the public in a customer service role.
</li></ul><ul><li>Req Familiarity with word processing, Microsoft Outlook, GE Centricity Business, Cerner, PBAR, scheduling systems, and navigate the intranet, interpret on-line queries.
</li><li>Req Must have excellent communication skills, including the ability to speak, read and write English proficiently
</li></ul>Preferred Qualifications:
<ul><li>Pref Bachelor's degree Degree in a related field
</li><li>Pref 2 years Acute care, ambulatory care, or surgical center setting preferred.
</li><li>Pref Proven knowledge of insurance billing, admitting, or registration experience in a hospital or medical office preferred.
</li><li>Pref Knowledge of medical terminology preferred.
</li></ul>Required Licenses/Certifications:
<ul><li>Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
</li></ul>The hourly rate range for this position is $21.00 &ndash; $35.36. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate&rsquo;s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. 
USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying.
We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu . Inquiries will be treated as confidential to the extent permitted by law.
<ul><li>Notice of Non-discrimination
</li><li>Employment Equity
</li><li>Read USC&rsquo;s Clery Act Annual Security Report
</li><li>USC is a smoke-free environment
</li>Digital Accessibility 
<li>
</li></ul>If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser:
https://wd5.myworkday.com/usc/d/inst/1$9925/9925$145644.htmld</div>

Support Coordinator - Derm-Plastics Cl - Full Time 8 Hour Days (Non-Exempt) (Union)

<div><div>Description
This staff personnel reports to the Sleep Lab Manager and Supervisor to provide clerical and administrative assistant support to the UCLA Sleep Disorders Center DME business. Duties include: working in a fast-paced environment with frequent interruptions; answering a large volume of daily telephone calls; triaging and scheduling patient appointments including in some cases completing triage forms and faxing to doctors to complete the referral form; taking telephone messages from patients for the technologist and manager to call back; obtaining benefit and eligibility information and authorizations from insurance companies; performing billing procedures for patient visits; answering questions about the lab; providing parking directions; ordering office supplies on EMPAC for approval by the supervisor; coordinating with DME Technologist to update patient and staff materials. Assume overall clerical and administrative assistant responsibility for day-to-day coordination of the Sleep Disorders Center DME. The incumbent will coordinate efforts with Manager and Supervisor, DME Technologist, and other Sleep Center staff to ensure smooth operation of Sleep Center DME. Assist with cross-covering administrative assistants and providing other administrative support to the department as requested or as needed.

This person works under the direct supervision of the Manager and Supervisor, and will work closely with the DME Technologist and will perform tasks necessary to the day-to-day administration of the Sleep Lab DME. The incumbent will coordinate efforts for day-to-day functioning with the DME Technologist of the UCLA Sleep Lab DME. Work independently and as team member to ensure smooth functioning of Sleep Lab DME and ensure that work is prioritized so that tasks are completed.</div><div>
Qualifications<ul>
<li>
Skill in setting priorities and organizing workload, information, and people in such a way that accurately reflects the relative importance of job responsibilities in order to complete work in a timely manner accounting for deadlines, completing projects and a heavy workload.</li>
<li>Ability to work independently to follow through on assignments and projects without supervision. Ability to work with frequent interruptions and changing priorities.</li>
<li>Skill in analyzing information, problems, situations, and procedures to a) define the problem or objective, b) identify problem solving possibilities, c) determine the best course of action, and d) implement as necessary. Ability to take action when answers to a problem are not readily available.</li>
<li>Ability to establish and maintain cooperative working relationships with colleagues, faculty, staff, and patients.</li>
<li>Ability to draft original business correspondence (e.g., memos and letters) and edit materials using correct grammar, punctuation, spelling, and format without any notes or guidelines for reference.</li>
<li>Excellent oral communication skills to transmit and obtain information using appropriate vocabulary and grammar, including the ability to handle incoming telephone calls effectively, triage patient problems to appropriate physicians, and provide information about programs and services.</li>
<li>Skill in using a variety of Microsoft programs (e.g., Word, Excel) to update materials, reports, and documentation.</li>
<li>Ability to process all aspects of reports (typing/transcribing, proofing/editing, uploading, distribution, and filing).</li>
<li>Ability to schedule appointments accurately following established policies and procedures and to complete pre-processing activities in a timely and accurate manner (e.g., providing information, confirming appointments, processing referrals and authorizations).</li>
<li>Ability to perform clerical functions related to scheduling, triaging, reporting, and billing and to coordinate with staff.</li>
<li>Skills in using computer systems for email, scheduling, report transcription and retrieval, and data entry/registration.</li>
<li>Ability to instruct and train administrative personnel in job duties following standard policies and procedures.</li>
<li>Experience working with Durable Medical Equipment (DME) and related processes preferred.</li></ul></div></div>

Administrative Assistant III - Sleep Lab

Home Health

<div>The Corporate Clinical Documentation &amp; Chart Audit Specialist is responsible for conducting comprehensive chart audits across all long-term care (LTC) providers within the health system. This role ensures accuracy, compliance, and optimization of clinical documentation, billing practices, and regulatory adherence.

The Specialist works collaboratively with providers, facility leadership, and corporate operations to identify documentation gaps, improve provider performance, and support revenue integrity initiatives. This position operates in a hybrid capacity, requiring both in-office presence and remote work, with occasional travel to facilities as needed.

Chart Auditing &amp; Compliance
<ul>
<li>Conduct routine and targeted chart audits for LTC providers as directed by corporate leadership</li>
<li>Evaluate documentation for:</li>
<li><ul><li>Clinical accuracy and completeness</li>
<li>Regulatory compliance (federal, state, and payer-specific)</li>
<li>Billing and coding alignment</li>
<li>Medical necessity and appropriate level of service</li>
</ul></li><li>Identify trends, deficiencies, and areas of risk across providers and facilities</li></ul> 


Provider Engagement &amp; Education
<ul>
<li>Meet directly with providers (in-person or virtual) to review audit findings</li>
<li>Provide clear, professional feedback with actionable recommendations</li>
<li>Deliver ongoing education to improve documentation quality, compliance, and productivity</li>
<li>Support providers in correcting deficiencies and implementing best practices</li></ul> 


Tracking, Reporting &amp; Analytics
<ul>
<li>Maintain a comprehensive audit tracking system, including:</li>
<li><ul><li>Providers audited</li>
<li>Frequency and scope of audits</li>
<li>Findings and trends</li>
<li>Follow-up actions and outcomes</li>
</ul></li><li>Generate regular reports for corporate leadership highlighting:</li>
<li><ul><li>Compliance trends</li>
<li>Provider performance</li>
<li>Revenue impact and missed opportunities</li>
</ul></li><li>Collaborate with leadership to adjust audit focus based on organizational priorities</li></ul> 


Operational Collaboration
<ul>
<li>Partner with regional and facility leadership, including CEOs, clinic managers, and corporate teams</li>
<li>Align audit processes with system-wide goals for productivity, compliance, and revenue integrity</li>
<li>Assist in developing standardized audit tools, scorecards, and workflows</li>
<li>Participate in process improvement initiatives related to documentation and billing</li></ul> 


QUALIFICATIONS:

Education &amp; Experience
<ul>
<li>Licensed healthcare professional required (RN or APRN)</li>
<li>Minimum of 3&ndash;5 years of experience in long-term care, clinical documentation, coding, or compliance required</li>
<li>Experience with chart auditing, EMR systems, and provider documentation review required</li>
<li>Knowledge of CMS guidelines, Medicare/Medicaid regulations, and LTC billing practices strongly preferred</li></ul> 


Skills &amp; Competencies
<ul>
<li>Strong analytical and critical thinking skills</li>
<li>Excellent communication skills with the ability to provide constructive, professional feedback</li>
<li>High level of organization and ability to manage multiple audits and timelines</li>
<li>Proficiency in data tracking and reporting (Excel preferred)</li>
<li>Ability to work independently while collaborating across multiple facilities</li></ul> 


Work Environment &amp; Expectations
<ul>
<li>Hybrid role: combination of in-office and remote work</li>
<li>Occasional travel to LTC facilities across the system</li>
<li>Regular interaction with providers and executive leadership</li>
<li>High level of confidentiality and professionalism required</li></ul> 


Key Performance Indicators (KPIs)
<ul>
<li>Audit completion rates and timeliness</li>
<li>Improvement in provider documentation quality</li>
<li>Reduction in compliance risks and deficiencies</li>
<li>Measurable improvement in revenue capture / reduction in missed opportunities</li>
<li>Provider engagement and follow-through on recommendations</li></ul> 


Reporting Structure
<ul>
<li>Reports to: Vice President of Long-Term Care Operations</li>
<li>Works closely with: Corporate compliance, finance, and facility leadership teams (CEOs, Regional LTC Directors and office managers)</li></ul></div>

Corporate Clinical Documentation & Chart Audit Specialist (RN/APRN)– Long-Term Care

Metropolitan Industries

<div><div><div>Benefits:</div>
<ul><li>401(k)</li>
<li>Bonus based on performance</li>
<li>Competitive salary</li>
<li>Opportunity for advancement</li>
</ul></div><div><div>Position Summary</div>
<div>We are seeking a Accounting Administrative Assistant to join our team! The Accounting Administrative Assistant provides documentation, filing, and reporting support to the Accounting Manager and Accounting Clerk. This role ensures accounting records are organized, complete, and audit-ready, while assisting with preparation of draft financial reports and monthly close documentation. The ideal candidate has experience working in customer service, is extremely organized, and can maintain the highest level of confidentiality.</div>
<div></div>
<div>Key Responsibilities</div>
<ul><li>Maintain organized digital and physical accounting files</li>
<li>File and index:<ul>
<li> Vendor invoices</li>
<li> Bank statements</li>
<li> Insurance policies</li>
<li> Property tax bills</li>
<li> Loan and lender statements</li>
</ul></li><li>Assist in preparing draft reports, including:<ul>
<li>Expense summaries</li>
<li>AR and AP aging reports</li>
<li>CAM backup schedules</li>
</ul></li><li>Assist with preparation of monthly rent billing packages.</li>
<li>Organize documentation for monthly close</li>
<li>Assemble documents for audits, lenders, and ownership requests</li>
<li>Track reporting deadlines and missing documentation</li>
<li>Support onboarding of new properties from a documentation standpoint</li>
</ul><div>Qualifications</div>
<ul><li>3+ years of administrative or accounting support experience preferred</li>
<li>Strong organizational and documentation skills</li>
<li>Experience supporting accounting or finance teams a plus</li>
<li>Real estate or property management experience preferred but not required</li>
<li>Proficiency with Microsoft Office, OneDrive, DropBox and cloud-based file systems</li>
<li>High attention to detail and confidentiality</li>
</ul><div>Location</div>
<div>This is an on-site position located in Downtown Los Angeles. 
Candidates must be able to reliably commute to DTLA.</div></div></div>

Accounting Administrative Assistant

Humana

<div><h1 class="jobSectionHeader">Become a part of our caring community 
</h1>
The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new delivery models. Maintains efficient operations while ensuring attainment of quality of care and financial goals. Provides information for pricing guidelines based on utilization patterns and client demographics. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise.
The Behavioral Health Medical Directors will learn Medicare, Medicare Advantage and/or Medicaid requirements, and will understand how to operationalize this knowledge in their daily work.
The Behavioral Health Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. The Behavioral Health Medical Directors support Humana values, and Humana&rsquo;s Bold Goal mission, throughout all activities.<h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Required Qualifications<ul><li>MD or DO degree</li><li>5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population</li><li>Current and ongoing Board Certification an approved ABMS Medical or ABPN Specialty</li><li>A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.</li><li>No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.</li><li>Excellent verbal and written communication skills .</li><li>Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.</li></ul>
Preferred Qualifications<ul><li>Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.</li><li>Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.</li><li>Experience with national guidelines such as MCG&reg; or InterQual</li><li>Psychiatry, Internal Medicine, Family Practice, Geriatrics, Hospitalist, or Emergency Medicine clinical specialists</li></ul>
&bull; Advanced degree such as an MBA, MHA, MPH&bull; Exposure to Public Health, Population Health, analytics, and use of business metrics.<ul><li>Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.</li><li>The curiosity to learn, the flexibility to adapt and the courage to innovate</li></ul>
Additional Information
Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business.
#physiciancareers
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$223,800 - $313,100 per year 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Behavioral Health Medical Director

Explore 832+ Director of physicians billing office customer service in Los Angeles this May. Find roles across top companies and apply now to boost your career.