Search- VP Sales | Virtual

Possessing the ability to identify the right technology to solve current and emerging problems our award winning client is recognized as a market leader. This is an excellent opportunity for a professional with sales leadership experience to join a team that is building on decades of product expertise, innovations, strategic partnerships and leading edge technology.

This position offers the opportunity to become the driving force in bringing high impact solutions that revenue cycle leaders need and want to talk about.

The sales VP will work autonomously from their virtual home office, leveraging their hospital revenue cycle contacts to build a new territory. This position is ideal for a consultative sales pros who knows how to identify needs and wants to have the tools to fill them.

Great benefits, six-figure sales compensation, and a “get it done” company culture will be used attract the best of the best with healthcare sales experience.

Technology/ Team/ Experience/ Brand + You = Outstanding Career Move

Find this interesting enough to warrant a further conversation?

Click Here to Contact Us

A mid-west headquartered company that brings innovative and practical solutions to hospitals and payers. They bring the tools to the marketplace so their clients can get ahead of revenue cycle, eligibility, and appeals/denials management issues.

Search- Manager Provider Relations|East Coast Location

Pam Ratz DeVille, Executive Consultant with Managed Medicaid Services announces a search for a Manager of Provider Relations. Managed Care Organizations are expanding rapidly to meet growing demand and they look to Pam to help them attract the top talent from the industry.
Want more details?

Contact Pam today to set up a confidential conversation.



Pamela Ratz DeVille, CPC, CIR, CDR |
866-371-0687 X 256 office

Manager Provider Relations

Foster collaboration with the provider community as the Manager of Provider Relations. A strong leader with a desire to stay innately connected to the requirements of state and federal health programs will stand out as a prime individual to enhance and develop the team at this growing Managed Care Organization.

Duties Include:

– Responsible for maintaining existing and developing new provider relations, and assisting with contracting activities.
– Manage the staff in contracting area including work flow, training and communication standards.
– Manage day-to-day provider relations activities and provider relations department.
– Develop, implement and maintain production and quality standards for the contracting staff.
– Monitor and analyze costs and prepare departmental budget.
– Initiate and execute standard physician and ancillary provider contracts.
– Coordinate all pre-contract activities with providers such as, site visits, credentialing, orientation to contractual requirements, etc.
– Maintain contracts and correspondence files in organized and accessible manner for all providers.
– Prepare and analyze information to evaluate the need for additional health plan providers.
– Manage and coordinate customized provider contracts and hospital contracts.
– Participate in physician and ancillary provider contracting and provider relations in foreign state markets through implementation and startup phases.


Bachelor’s Degree or equivalent experience. 4-6 years of Managed care or health delivery system experience including project and staff management experience. Experience with state and federal health programs such as Medicaid and Medicare. Provider relations/contracting experience including solid communication and negotiation skills.

New Search: Medical Director-Southern Location

Richard Yadon, President of Managed Medicaid Services has initiated a search for a Medical Director for a key southern health plan. The selected individual will have the opportunity to provide the medical leadership that will ensure excellent quality of care and service is provided to all of members of the plan.

Would you like to learn more? Schedule a confidential phone consultation with Richard to determine if this role would be an ideal fit for you. Click Here For Schedule

Use your prior experience to lead/direct the following key functions:

Provide technical expertise in medical management by direct decision making in the areas of pre-authorization, concurrent review of hospitalized patients, discharge planning, complex case and chronic care management, and credentialing.

Oversee the clinical aspects of the quality management, credentialing, pharmacy, and medical management program.

Chairs (or staffs) all peer-review committees such as Quality Improvement, Pharmacy and Therapeutics, Credentialing, and others that are deemed appropriate for the health plan. Take part in periodic consultations and/or conversations with peers and practitioners in the field.

Analyzes medical cost drivers and develops specific plans to reduce excessive cost.

Works with senior leadership to develop strategic approaches to improve company performance and expand growth by optimizing provider network, evaluating provider (hospital, physician, ancillary) contracts, and developing other creative approaches.

New Search: Chief Marketing Officer

Chief Marketing Officer

Primary Skills: Bachelor’s degree, Sr. Level Marketing Exceutive with Medicare Part D experience.
Description: The Medicare Part D Chief Marketing Officer will develop and implement marketing and communications strategies for enrollment, member communications and member retention. Utilizie multiple communications tools and channels. and work cross-functionally within the Marketing & Communications group and across the organization. Build and supervise a Medicare marketing team to support the growth of diverse markets.

Provide professional expertise on Medicare benefit design and the regulatory environment.
and build effective, strategic working relationships with product, sales, and regulatory leaders. Manages internal stakeholder expectations around marketing plans, messaging, priorities, budget, and time lines. Support various internal departments to develop communication plans for current Medicare members. Develops strategic and tactical marketing plans based on current business strategy. Serve as Subject Matter Expert on promotions, communications, event marketing and campaigns to develop and delivering targeted and effective messages to our target Medicare population. Work with Compliance Department to ensure all marketing communications are compliant with CMS guidelines and regulations. Works closely with retail and insurance company partners to develop and implement an Agent Sales strategy to support sales goals.
Assist with copy writing and reviewing of various marketing materials. Maintains CMS submission library of letters and other CMS communications. Manages submission process with CMS.

Requirements :
Extensive expertise with CMS, Medicare and Part D regulations. 4-year degree in Health Care Administration, Marketing, Business, Communications, or related field. 7+ relevant insurance company, PBM, health care payor, and/or government health plans. Experience in leading and partnering with cross functional teams to accomplish a common goal.

7-10 years relevant insurance company, PBM, health care payor, and/or government health plans

Can you hear the BUZZ? We are growing!

Our firm is busier than a bee in spring and we are GROWING our team!

• Fastest Growing Segment of the Healthcare Industry
• Unlimited Income Potential
• Zero Travel
• Customer Focused
• High Impact Role

Does building a career within one of the fastest growing segments of the healthcare industry (Medicaid/Medicare) interest you? Have you mastered the fine art of being customer focused all while being sales minded?

Landing over a $100,000 dollars in new business this month this is the perfect time to expand our team. -Richard Yadon, President Managed Medicaid Services

Then we may be looking for you.

As a Recruiting Coordinator you will work side-by-side with our experienced recruiting team. Learning the recruiting process from the ground up your intial work will be focused on co-ordination, communication and outreach activities. All the activities related to high level executive searches. As you master the steps in our process you will be given the opportunity to lead portions or entire sales projects. Some of the activities you’ll perform include database entry, prospecting, internet research, account management, scheduling activities, preparing marketing materials, and credentialing.

This is ideal for:

* B2B Salespeople who want to enter the executive search and recruiting industry
* Outside salespeople who want to work from an office
* Telephone salespeople who want a professionals services job

We provide you with:

* Complete Training
* Comfortable, family friendly offices in Brentwood/Franklin near the Cool Springs Mall
* Base salary and performance incentives
* Industry tools and resources
* Substance free work environment

You need to bring:

* Sales Experience – at least two years of sales experience in sales such as, mortgage, hospitality, health care, office supply, or business to business sales.
* Ambition – Motivation for achievement and financial gain
* Ability and desire to proactively introduce yourself over the telephone
* A strong work ethic and willingness to work before or after “normal” business hours if necessary
* A competitive attitude
* An high level of initiative
* Proven organizational and administrative skills
* Good relationship building skills
* Advance MS Word, Excel, Outlook, Internet search skills


Please apply only if you are within a commutable distance to our main office in Cool Springs (37027).

Case Manager |RN |IL |Search

Medicaid Case Manager RN

Medicaid Case Manager RN

Join an organization that TRULY values their nurses! This is a rare opportunity for an RN with experience in UR to step into a managed care setting with plenty of room for growth. Review inpatient admissions to assure appropriate level of care and medical necessity. This will be done on site and tele phonically. Audit patient charts through on-site hospital visits, act as clinical resource to referral staff and make appropriate referrals. Educate patients and providers. Enters assessments, authorizations and reviews into the system.

Position requires an RN with min. 2 yrs clinical exp and UR exp. Current state nursing and driver’s license.

Knowledge/Experience: At least two years clinical nursing experience.


VP Compliance | AZ | Search

Growing specialty health company! Ensure regulatory compliance with state and other government agencies related to the health insurance industry, corporate and its business subsidiaries. Ensure business unit and corporate are in compliance with state and federal program regulations insurance regulations regulatory requirements for business entities and state contract requirements. Maintain and track laws and regulations contract documentations amendments and various compliance measures. Develop policies procedures and processes to comply with state law federal law contract requirements and various standards. Oversee administer and implement various compliance programs including fraud and abuse and HIPAA. Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language. Conduct compliance audits develop and implement corrective action plans and report on achievement of action plans to senior management. Develop strategic relationships with state legislative policymakers and assist with the development of state legislative public policy concerning state insurance Managed Care Organization Medicare and Medicaid regulations and initiatives. Identify evaluate and analyze the impact of state legislative and regulatory issues and advise management concerning impact. Represent senior management at various committees meetings and seminars

Position requires a Bachelors degree in Public Policy Government Affairs Business Administration or related field. 5+ years of compliance program management and contract experience. Extensive knowledge of state administrative code and regulations state insurance laws and regulations including managed care regulations. Experience with state and federal government agencies accreditation bodies participating provider agreements HIPAA and Third Party Administration (TPA) laws credentialing regulations and prompt pay laws. Master’s or Law degree preferred.


Executive Recruiting Contact:
Pamela Ratz DeVille, CPC, CIR, CDR
DL: 866-371-0687 x256

VP Medical Management |Washington | Search

Select your own team to grow and develop! Establish and implement the strategic vision for all medical management and quality functions in WA. Review and analyze all activities, costs, operations and forecast data to determine department progress. Participate with executive committees on special studies. Administer and ensure compliance with NCQA and/or JACHO standards as determined for accreditation of the health plan. Participate in staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars. Get involved with provider education and contracting activity as appropriate.

Successful candidate will have Bachelor’s degree in nursing, or equivalent experience. 10+ years of clinical nursing, quality improvement, and management experience in a managed care setting. Thorough skills knowledge of quality improvement practices. Familiarity of medical information systems, medical claims payment process, medical terminology and coding. Familiarity of case management practices, managed care, and Medicaid programs. Familiarity of NCQA accreditation process and standards.


Executive Recruiting Contact:
Pamela Ratz DeVille, CPC, CIR, CDR
DL: 866-371-0687 x256

Sr. Clinical Systems Specialist| Informatics RN |Search

Tech-savvy RN will promote medical management processes and manage application integration throughout numerous areas of the organization to promote effective collaboration. Identify opportunities for process adjustments and redesign related to new business, new and existing programs. Formulate and manage work plans related to system or process initiatives. Direct and/or perform testing related to application upgrades and/or modifications. Maintain all aspects of the application described as clinical content. Monitor, analyze and coordinate resolution of large scale application issues related to the transfer of member and provider, and/or authorization data. Maintain MM web page for the Clinical System Management Unit. Work as a team with other RN’s performing similar work.

Bachelor’s degree in nursing, RN, 5-7 years of related experience. Project management in a clinical environment preferred. Ability to integrate nursing knowledge to enhance business optimization and application development. Ability to travel approximately 20%.

Executive Recruiting Contact:
Pamela Ratz DeVille, CPC, CIR, CDR
DL: 866-371-0687 x256

Apply Here

Chief Medical Officer | Search

EXECUTIVE PHYSICIAN will drive all medical management efforts, quality improvement and credentialing functions for the LA business unit. Successful candidate will serve as clinical advisor to and educator of medical management staff. Oversight of internal medical review guidelines to ensure clinical integrity and compliance. Responsible for regulatory accreditation concerns pertaining to medical management issues. Handles medical review activities pertaining to the complex, controversial, or experimental medical services. Facilitates the achievement of the Medical Management Program goals through an effective health services delivery system. Responsible for physician review and oversight of all potential adverse determinations including pre-certifications/prior authorizations, concurrent review and appeals/retrospective review. Responsible for HEDIS improvement and strategy. Actively participates in the auditing process of medical management processes and corrective action team projects for medical management. Achieves utilization, cost management and quality goals. Participates and advises in the development of corporate medical policies for UM, pharmacy, and new technology.

Position requires a Medical Doctor or Doctor of Osteopathy, board certified in a specialty recognized by the American Board of Medical Specialists. Previous experience as Medical Director required. Master’s degree in Business Administration, Public Health, Healthcare Administration or related field preferred. Strong preference for experience in LA.

Apply Here

Executive Recruiting Contact:
Pamela Ratz DeVille, CPC, CIR, CDR
DL: 866-371-0687 x256