- Travelers Insurance Company (Hartford, CT)
- …business outcomes. " The BI Actuarial Product team is looking to hire a Director of Actuarial and Analytics. This person will be the actuarial lead on specific ... Specialty coverages starting in Inland Marine, partnering heavily with...strategies. They will also manage more junior staff. The Director , Actuarial and Analytics is an analytic leadership role… more
- Rising Medical Solutions (Chicago, IL)
- …providing strategic direction for Rising's Specialty Services unit involving complex /large medical claims ; analyzing and optimizing bill review procedures ... As our Director of Specialty Bill Review Services,...an expert witness as required. + Research and answer complex questions regarding CPT, ICD-9, HCPC and other codes,… more
- AON (Chicago, IL)
- Managing Director , Professional Services Practice, Commercial Risk Are you a proven leader that can identify and generate growth opportunities? Are you a proven ... colleagues and clients succeed. What The Day Will Look Like Managing Director , Account Executive and Team Leader responsible for delivering risk financing consulting… more
- Travelers Insurance Company (St. Paul, MN)
- …and agents. This role supports the Business Insights Delivery needs of the Claim organization within Bond & Specialty Insurance. The Business Insights Delivery ... Claim leadership to monitor business results. As the Director , Business Insights Delivery, you will lead the strategic...fit long-term business partner roadmaps. You will build highly complex data stories and present to management to enable… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- …adult veterans with complex chronic diseases and neuropsychiatric illnesses in complex legal and psychosocial environments. The Medical Director should be ... on moonlighting The Home Based Primary Care (HBPC) Medical Director serves as the physician member of the HBPC...and use of geriatric assessments, primary care management of complex chronic illnesses, ability to evaluate for decision making… more
- Humana (Columbus, OH)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director (Staff Geriatrician or Physician with Ten (10) ... Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of...Current and ongoing Board Certification an approved ABMS Medical Specialty + No current sanction from Federal or State… more
- Humana (Columbus, OH)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of...Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at… more
- AbbVie (Houston, TX)
- …@abbvie on Twitter, Facebook, Instagram, YouTube and LinkedIn. Job Description The Director of Reimbursement Business Advisor (DRBA) leads a field team of ... including: Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation,… more
- Veterans Affairs, Veterans Health Administration (Boston, MA)
- …position in Boston, Massachusetts in vibrant and diverse clinics. The Medical Director is responsible for ensuring that excellent, high-quality care is provided to ... 50% administrative time. This person will be the Medical Director for the five VA Boston Community Based Outpatient...Based Outpatient Clinics. VA Primary Care Physicians manage a complex panel of patients in collaborative teams. Panel sizes… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …Extended Care service line is looking to hire a Physician - Assistant Medical Director . This position is eligible for the Education Debt Reduction Program (EDRP), a ... for a full-time Rehabilitation and Extended (REC) Care Associate Medical Director - Internal Medicine Physician/Family Practice Physician/Geriatrician, for the REC… more
- CVS Health (Columbus, OH)
- …Summary: Primary Responsibilities: * Responsible for clinical oversight of DSNP/MMP complex populations (Duals Special Needs/MMP* Develop and lead clinical strategy ... management, reimbursement methods and treatment protocols for DSNP/MMP and other complex health populations to optimize risk adjustment, clinical quality, and care… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …of psychiatric assessment services and diagnoses mental disorders, particularly for complex or unusually difficult patients. Provide consultation to all staff in ... Attend regular meetings and coordinate with affiliate's psychiatry residency training director , medical student and osteopathy students' training directors. As the… more
- Centene Corporation (New York, NY)
- …to providers that would improve utilization and health care quality. + Reviews claims involving complex , controversial, or unusual or new services in order ... perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement… more
- Centene Corporation (Columbia, SC)
- …to providers that would improve utilization and health care quality. Reviews claims involving complex , controversial, or unusual or new services in ... perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement… more
- House of Blues (Los Angeles, CA)
- …and appeals - involving bodily injury, premises liability, and/or other types of tort, complex , or specialty cases + Expertise in Title III of the Americans ... read on! THE ROLE Live Nation is seeking a highly qualified and experienced Director of Litigation, General Liability & Disability Access to join our legal team. In… more
- CVS Health (Springfield, IL)
- …Strategy team under the Pharmacy Benefits Management (PBM) business unit. The Director , Network Strategy will partner with senior executives on developing how we ... requiring partnership with advanced analytic and financial talent. The director will be a data-driven leader with the ability...be a data-driven leader with the ability to distill complex analyses and concepts into insights that are packaged… more
- Arvinas (New Haven, CT)
- …in manipulating and extracting insights from large longitudinal data sources, such as Claims , EMR, Specialty Pharmacy and other patient level data sets required. ... For more information, please visit www.arvinas.com . **Position Summary** This Associate Director of Sales Operations Analytics will be responsible for leading sales… more
- Humana (Columbus, OH)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Nuvance Health (Danbury, CT)
- Director Patient Access Pre-Services Location: Danbury, CT, United States Requisition ID: 36698 Salary Range: 49.76 - 92.40 HOURLY Work Shift: Day shift hours ... Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider… more
- The Cigna Group (Bloomfield, CT)
- …to utilization management, case management, network, contracting, pharmacy, and service operations ( claims ). This is an entry to mid-level position for a physician ... interested in a career in health care administration. The Medical Director role is a Medical Principal who also manages 2 or more direct reports. **Major… more