Showe and Associates LLC
Executive Recruiting Services for the Managed Healthcare Industry
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Work for a major health system in a visible position leading managed care contract modeling and analytics in relation to negotiations with insurance payors. Job Summary Develops and maintains analytical tools, manages and trains staff, and uses data to provide recommendations on reimbursement methodology and rates for managed care contracts. Prepares financial analyses of current state, models the financial impact of potential reimbursement methods and rates, and determines the optimum....

- Woodland Hills, CA

Claims Manager Woodland Hills, CA USABenefits:401K, Dental, Life, Medical, VisionClaims Handled: Commercial Property / Subro / SIU / HomeownersDirect Reports: 2-6Claims Manager - Property will have an exciting opportunity to steer the entry of cannabis-related property insurance into market in several states. We are looking for someone who has the required knowledge of commercial property coverages, able to travel occasionally, and is skilled in training and managing new employees.SUMMARY This


Full Time or Part Time- We are in search of an Associate Medical Director Board Certified in Medical Oncology (all adult care) or Board Certified Hematology/Oncology candidates. To be considered you should have current clinical experience of at least 5 years in Medical Oncology or Hematology/ Oncology. This is a remote opportunity to be working from home anywhere in the USA. We are looking for the new hire to start as soon as possible or by September 1st. This is a new, add-on role for our....


Director, Quality Improvement_____________________________________________________________Director will work closely with the VP across all product lines for the growing Missouri market Exceptional growth- generous relocationLead and direct process improvement activities that provide more efficient and streamlined workflow.Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information....


VP, Health Services | Medical Management - Little Rock ___________________________________________________________ VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist for the Medicaid product in this market. Incredible growth opportunities and perks for this executive role GENEROUS relocation & competitive compensation. ** We are seeking an experienced leader with a proven background in an MCO/health plan/ACO. Direct and coordinate....


SR DIRECTOR – HEDIS – CORPORATE ROLE – NATIONAL – MIDWEST BASED __________________________________________________________________ Are you passionate about HEALTHCARE QUALITY ? AMAZING opportunity to drive the design, development, deployment of NEW methods of analyzing population data. Oversight for HEDIS, STARS, QRS, state performance data and CAHPS data. GENEROUS RELOCATION – INCREDIBLE technology, tools and resources!!!! Oversee all advanced analytic methodologies and processes involving....

- Chicago, IL

Chief Operating Officer (COO) Midwest ________________________________________________________ Forward- thinking strategist will lead continued growth and strategic development in this expanding health plan market as COO. Excellent growth opportunities - GENEROUS incentives and equity This is THE opportunity to challenge your operational, financial and relationship-building strengths to move the needle on healthcare quality and ensure continued financial success and growth for this....


VP Medical Management | Health Services - South Carolina_______________________________________________________________________________ VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist in this market. Incredible growth opportunities and perks for this executive role GENEROUS relocation & competitive compensation. ** We are seeking an experienced leader with a proven background in an MCO/health plan/ACO. Direct and coordinate the....

- Baltimore, MD

Chief Medical Director - Baltimore, MD__________________________________________________If you are seeking a truly purposeful career with an opportunity to improve quality of care for vulnerable populations, and do MUCH more than UR, you may wish to consider joining this health plan. GENEROUS relocation- excellent career growth! Executive Leader will direct and coordinate the medical management, quality improvement and credentialing functions for the Maryland market. Collaborate with health....


POSITION PURPOSECoordinates patient care requirements between the home infusion pharmacy, home health agency, hospital, physician office, managed care providers. This includes but is not limited to educating the community and other health providers regarding the services offered by Infusion Client, patient caregiver education/hospital discharge visits. Is able to coordinate total nursing care for patients in the home setting, participates in teaching patients and significant others medical....


Plant Manager Summary: The Plant Manager oversees all plant operations to ensure all customer requirements are met on the plant floor on a timely basis. This position will direct and coordinate activities of the company operation/plant to obtain optimum efficiency and economy of operations and maximize profits. Plant Manager Job Responsibilities:Responsible for the plant operational activities to ensure the safety of associates, high product quality standards and production schedules are met....


Job DescriptionA National leader in the custom home building industry, is looking for a General Manager in Chesapeake, VA.An ideal candidate must possess a strong work ethic, problem-solving skills, and knowledge of residential construction. Someone from/familiar with the Hampton Road's area & knows the local vendors/subs/etc to acclimate more quickly to the operations. They are looking for the right person with “high energy” and constantly driving the Sales/Production process.....


Director of Patient Services: POSITION SUMMARY:Overall responsibility for planning, organizing, directing, and coordinating healthcare and professional services of a Private Pay Licensed Home Care Services Agency throughout the Greater NYC area.Overseeing the clinical operation of private home care.Working closely with Recruitment, Sales, and Corporate OperationsEnsuring services maximize client satisfactionEnsure all clinical programs operate within the standards of NYS LHCSA rules, and....


Our client enjoy's a company culture of passionate advocacy in a supportive work environment with opportunities for growth and learning, competitive salaries, and a generous and comprehensive benefit package. What you will do as the Senior-Level Provider Contract Manager is develop, negotiate, manage, and lead intricate contractual, legal, and financial arrangements with providers to ensure the organization's members have great access to the highest quality, cost-effective....


New Medicaid/Medicare Health Plan in state of AZ is seeking a Chief Medical Officer who will be responsible for contributing to and achieving overall company goals for company growth and financial performance. This is an opportunity to be part of the ground up build of a Medicaid health plan and help secure new business opportunities.The Chief Medical Officer - CMO - will be responsible for strategic oversight of comprehensive medical policies including development, implementation, and....


Nationally recognized integrated health plan seeks a Director of Utilization Management to lead a CM / UM team in Southeastern Massachusetts. The Director of Utilization Management will: Manage criteria-based reviews of care, clinical appeals regarding medical necessity, and the interaction with claims payment policies and processes.Support goals, contracts, and accreditation requirements of health plan by conducting reviews of clinical interactions and clinical documentation including reviews

- Milwaukee, WI

Behavioral Health Care Manager - Milwaukee ______________________________________________________________________________________________________Phenomenal team and strong career growth as part of this international health plan offering a fully integrated program of care.You CAN make a difference! -Working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues.Care Manager will -Assess....


Nationally recognized health plan seeks a VP Chief Medical Officer to provide system-wide strategic clinical guidance. The Chief Medical Officer will provide leadership in:Physical health and behavioral health care managementQuality ImprovementClinical operationsClinical informaticsShort and long-term program development and strategic planning for Medicaid and Medicare managed care.Leading medical teams for new business acquisition and turnaround initiatives,The design and implementation of....


Medicaid/Medicare Health Plan in state of Florida is seeking a Chief Medical Officer who will be responsible for contributing to and achieving overall company goals for company growth and financial performance. This is an opportunity to be part of the ground up build of a Medicaid health plan and help secure new business opportunities.The Chief Medical Officer - CMO - will be responsible for strategic oversight of comprehensive medical policies including development, implementation, and....

- Richmond, VA

Medical Director Growing integrated healthcare provider seeks a Medical Director to lead the company's utilization management clinical team in the state of Virginia. This is a remote role, but candidates must be licensed and live in Virginia. The Medical Director will:Oversee daily utilization management activities including reviewing requests and making coverage determinations for services and supplies for delegated lines of business.Act in a supporting role as medical manager and....

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