VP, Clinical Policy & Risk Excellence
Broughton Group
Broughton Group in Louisville, KY is seeking a Vice President, Clinical Policy and Risk Management to oversee the CM/UM Risk Management department. This role involves leading 5 direct reports and ensuring operational compliance with Medicare and Medicaid regulations. We seek a candidate with extensive experience in risk management and excellent leadership skills to foster quality and continuous improvement. This position offers a full-time schedule of 40 hours per week and the opportunity to make a significant impact in clinical operations. #J-18808-Ljbffr Broughton Group
- ...caring community Humana maintains a robust clinical risk management function to ensure effective... .... The Vice President, Clinical Policy and Risk Management will oversee a department... ...in complex, matrixed environments. Excellent communication skills and executive presence...PolicyRiskApprenticeship
- Humana Inc. is seeking a Vice President, Clinical Policy and Risk Management in Louisville, Kentucky. The role involves overseeing a risk management department, ensuring compliance within Care Management and Utilization Management processes, and leading risk mitigation...PolicyRiskFull time
- ...several outpatient behavioral clinics as well as consultative... ...market, technology, legislative policy, regulatory and reimbursement... ...relationships and practices, facilitate excellence in service, ensure continuing... ..., clinical effectiveness, risk management, medical staff...PolicyRiskFull timeWork experience placementWork at officeLocal areaDay shift
- ...services organization, the VP will oversee multiple... ...service delivery excellence, compliance, and innovation... ...programs, and nursing/clinical support (as applicable)... ...Compliance, Quality, & Risk Management Ensure all... ...and company compliance policies (HIPAA, FDA, OIG, and manufacturer...PolicyRiskContract workWork at office
- ...strategic oversight of the organization's resident assessment and clinical reimbursement functions (MDS/RAI/CAAs/Care Planning) across... ...Resident Assessment Instrument (RAI). • Proactively identifies risk areas, leads mitigation strategies, and ensures audit readiness...RiskWeekly payLocal area
$238.83k - $341.19k
...plays a key role as part of the clinical operations team providing... ...along with participating in risk and quality management programs... ...patient care compliance, and policies and procedures. ESSENTIAL... ...review to promote a culture of excellence. Anticipates variations in...PolicyRiskHourly payFull timeWork at officeImmediate start$100k - $130k
...designed to enhance our accuracy and mitigate risks. Our growth objectives and strategy are... ...a documented system of accounting policies and procedures. Manage growing accounting... ...oriented and organized. Advanced Microsoft Excel skills and experience with Microsoft...PolicyRiskContract workWork at officeLocal area- ...Vice President of Risk Management Churchill Downs Incorporated... ...participation in mediations. The VP monitors liability exposure... ...management experience preferred. Excellent analytical, problem solving,... ...with commercial insurance policies. Experience working with a captive...PolicyRiskContract work
- ...within specific U.S. states. Our current policies are based on the laws in states in which... ...of pricing strategies from the individual risk to portfolio levels using models and methodologies... ..., reporting results, training, etc. Excellent analytical, research, documentation and...PolicyRiskWork experience placementRemote workFlexible hours
$50k
...Indiana. The Vice President (VP) of Patient Support Services... ...clients, ensuring service delivery excellence, compliance, and innovation in... ...Compliance, Quality, & Risk Management Financial & Operational... ...deadlines for all corporate policies and procedures Ensure all...PolicyRiskTemporary workWork at officeImmediate start- ...,United States Job Category Clinical, Operations Employee Type FT... ...innovation, compassion, and excellence. We're looking for passionate... ...Clinical Services serves as the Risk Manager for the Health Plans.... ...delivery of standards and policies within budgetary guidelines....PolicyRiskContract workWork at officeLocal areaWork from home
- ...VP, Strategy and Transformation UofL Health Louisville, KY... ...prioritization, milestone tracking, risk mitigation, and executive... ...strategic advisor to executive, clinical, and operational leaders,... ...accountability, and execution excellence Promote adoption of hypothesis...RiskFull timeWork at office
- ...the enterprise. The VP will own enterprise-... ...closely with product, clinical, operations, security,... ...architectures AI Center of Excellence (AI CoE) Technology... ..., and model usage policies Responsible AI, security, compliance, and risk alignment (HIPAA, PHI handling...PolicyRisk
- ...within specific U.S. states. Our current policies are based on the laws in states in which... ...of pricing strategies from the individual risk to portfolio levels using models and methodologies... ...and interpret financial statements. * Excellent interpersonal skills. * Exceptional...PolicyRiskWork experience placementRemote workWork from homeFlexible hours
- ...day. Job Description: The System VP of Pharmacy is the senior-most pharmacy... ...for strategic direction, operational excellence, clinical quality, and financial stewardship across... ...adoption, white/brown-bagging policies, site-of-care shifts, and product standardization...PolicyContract workShift workDay shift
$10 per hour
...advice with a focus on client experience and risk management while deepening existing... ...sound risk management protocols and control policies and adhering to regulatory requirements... ...commitments Strong relationship-building and excellent communication skills with individuals at...PolicyRiskWork experience placementWork at office- ...Isaiah House Treatment Center Clinical Position Isaiah House is a faith-based and Christ... ...mental health needs. By following agency policies, HIPAA requirements, Kentucky standards,... ...safe, ethical, and effective care. Through risk assessments, safety planning, teamwork,...PolicyRiskFull timeWork at office
$138k
...Louisville, KY has an immediate need for a Clinical Pharmacist. Monday to Friday, daytime... ...laboratory tests for monitoring certain high risk conditions are ordered, evaluated and... ...Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance...PolicyRiskWork experience placementImmediate startRemote workRelocation packageMonday to Friday- ...PACT Clinical Pharmacy Practioner The PACT Clinical Pharmacy Practioner (CPP) functions... ...appropriateness and to reduce potential risk of adverse drug events. Uses population... ...Adheres to all medical center and department policies and regulations. Work Schedule:...PolicyRiskPermanent employmentLocal areaRemote workRelocation packageMonday to FridayFlexible hours
$10 per hour
...advice with a focus on client experience and risk management while deepening existing... ...sound risk management protocols and control policies and adhering to regulatory requirements... ...commitments Strong relationship-building and excellent communication skills with individuals at...PolicyRiskWork experience placementWork at office$270.46k - $386.37k
...people to join our team. The Market Clinical Director will directly supervise, performance... .... Technical knowledge and skills: Excellent clinical skills. Knowledge and... ...improvement processes. Experience of population risk management or complex chronic disease...RiskWork at officeLocal area$79.2k - $129.6k
...Clinical Medical Review – Oncology (Underwriting) (JR192475) Hybrid 1 : This role requires... ...an office. Please note that per our policy on hybrid/virtual work, candidates not within... ...acceptability of medically underwritten risks for more complex cases. Primary duties...PolicyRiskTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week- Join to apply for the Clinical Therapist role at Isaiah House Treatment Center 3 days ago Be... ...treatment guidelines and agency policies and procedures. This position provides therapeutic... .... Create safety plans, and assess client risk level through utilization of clinical...PolicyRiskFull timeRemote workRelocation packageAfternoon shift
$1,000 per month
...discrepancies, and denials. Risk Management & Compliance... ...ensure compliance with corporate policies, regulations, and quality standards... ...long-term operational excellence. Identify opportunities to... ...and more integrated care and clinical solutions in all 50 states to...PolicyRiskFull timeContract workWork from homeFlexible hours- ...ScionHealth Clinical Documentation Improvement Program Manager At ScionHealth, we empower... ...outcomes, severity capture, acuity, and risk of mortality reporting. Utilizes project... ...software Understanding of healthcare policy trends, regulatory requirements, and operational...PolicyRiskRemote jobWork at office
- ...reliability, and operational excellence of enterprise data center facilities... ...academic, research, clinical, and administrative systems.... ...compliance with institutional policies, industry best practices, and... ...excellence and attention to detail Risk management and resilience...PolicyRiskFull timeContract work
- ...andarchitecture, governance, auditing, risk management, compliance and enterprise security... ...an enterprise security stance through policy, architecture, risk management,... ...a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to...PolicyRiskFull timeWork experience placementRemote work
$28.94 - $51.83 per hour
...and service coordinator for high medical risks / needs members with comorbid behavioral... ...experience with MS Office, including Word, Excel and Outlook ~ Ability to travel 75% of... ...adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors...PolicyRiskHourly payMinimum wageFull timeWork experience placementLocal areaRemote workMonday to Friday- ...partner with your physician and offer 24-hour clinical care 7 days a week so you can start your... ...Initiates and enforces organization-wide policies and procedures that support the... ...Includes assessing the patient population, risk factors and the scope of services Contributes...PolicyRiskTemporary workWork at officeLocal area
- ...New Product Development and Global Liquid Excellence We believe great people build great... ...providing sound scientific recommendations and risk‑based decision‑making to stakeholders.... ...in all aspects of employment. It is the policy of Brown-Forman Corporation to provide full...PolicyRiskWork at officeLocal areaRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to VP, Clinical Policy & Risk Excellence. Be the first to apply!
- vice president sustainability Louisville, KY
- vice president media Louisville, KY
- vice president manufacturing Louisville, KY
- vice president Louisville, KY
- vice president business solutions Louisville, KY
- vice president corporate communications Louisville, KY
- vice president risk management Louisville, KY
- vice president program management Louisville, KY
- senior vice president of operations Louisville, KY
- senior associate vice president Louisville, KY


