- AIG (Jersey City, NJ)
- …role The Claims Complex Director will ensure high quality claims handling in the Casualty Specialty Claims Department. The role is responsible ... in Casualty Claims Join us as a Complex Claims Director to play...conclusions. * Working with experts to evaluate large, casualty specialty claims and articulate repair alternatives and… more
- Travelers Insurance Company (St. Paul, MN)
- …contributes to creating innovative solutions and improving business outcomes. This Director -level actuarial role performs and transforms Rate Adequacy for Commercial ... Initiatives team as well as teammates in Property and Specialty Actuarial Product to align Rate Adequacy with other...and relationship-building skills. + Ability to present and translate complex information in relevant business terms. + Strong PC… 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
- AbbVie (Irvine, CA)
- …the Associate Director will be responsible for acting as the Specialty Pharmacy Coordinator, helping to align the BOTOX reimbursement business advisors (RBAs) ... and implement tactics to exceed the ever-changing needs of offices, patients, and specialty pharmacies. The Associate Director is responsible for a continuous… more
- Veterans Affairs, Veterans Health Administration (Danville, IL)
- …coordination of care, and the integration of diverse services to cover complex medical, social, rehabilitative, and behavioral care needs. These Veterans need ... maximize function, minimize institutionalization, and maintain quality of life. The HBPC Medical Director , appointed by the Chief of Staff, is the physician who is… 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
- Humana (Columbus, OH)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to … more
- Lundbeck (Deerfield, IL)
- Associate Director Data Strategist Patient Acquisition - Remote Opportunity Requisition ID: 5342 Location: Deerfield, Illinois, US Do you want to join a team where ... the mission is meaningful, the challenges are complex , and you can directly see the results of...on neurology patient data assets (eg, data generated from Specialty Infusion Providers, Specialty Pharmacy, and Patient… 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 ... 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
- AbbVie (Mettawa, IL)
- …achieve their full treatment plan potential. AbbVie Patient Services Associate Director - Access and Reimbursement Marketing: Gastroenterology The Associate ... Director APS - Access and Reimbursement marketing reports to...knowledge of the payer landscape, buy and bill and specialty pharmacy acquisition models and familiarity with various sites… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN/LPN clinical reviewers as well as Support ... staff managing all areas of clinical claim pre and post audit, appeals submission, and reporting...complementary home and community-based pharmacy and health services for complex populations in need of chronic and/or specialized care.… more
- Pfizer (New York, NY)
- **ROLE SUMMARY** The Field Oncology Medical Outcomes Director is a field-based medical colleague responsible for providing therapeutic area/product expertise for a ... customers, including but not limited to National Payers, Regional Payers, and Specialty Pharmacy Providers (SPPs). The role is responsible for educating customers on… more
- Centene Corporation (Springfield, IL)
- …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
- 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
- Guthrie (Athens, PA)
- …physicians. 6. Demonstrates skills and proficiency in analyzing and troubleshooting complex reimbursement problems. 7. Analyzes and maintains Clinic fee schedule. 8. ... Formulates and effectively communicates recommendations to avoid recurrence of future claim rejections, denials, or errors. 12. Monitors coding rejections through… 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