- Humana (Helena, MT)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for ... services. The Medical Director work assignments involve moderately complex...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- CVS Health (Hartford, CT)
- …and more compassionate. And we do it all with heart, each and every day. Executive Director , Medicare Part D Strategy leader will lead the development and ... advancement of the organization's strategy for Medicare Part D, spanning both the ...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Elevance Health (Tampa, FL)
- ** Medical Director - Florida Medicare ...and expectations for time onsite will be discussed as part of the hiring process. The health of our ... must reside in Florida near our Miami or Tampa locations.** The ** Medical Director ** will support the following Florida Medicare plans: Simply Healthcare… more
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. **Position Summary** The Divisional CFO for Medicare Part D and Medicare Supplement is responsible for the financial ... + Serve as the chief financial partner to the Medicare Part D and Medicare ...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CVS Health (Hartford, CT)
- …the US. **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part C appeals (both provider and ... * Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation...in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance &… more
- Humana (Honolulu, HI)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims. The Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- BlueCross BlueShield of North Carolina (NC)
- …Data Interpretations, Finance, Finance Strategy, Financial Modeling, Health Insurance, Leadership, Medicare Advantage, Medicare Part D, Medicare ... **Job Description** Join our team as Director , Actuarial Services - Medicare Pricing...actuaries responsible for pricing, forecasting, and strategic support of Medicare Advantage, Medicare Supplement, and Part… more
- Elevance Health (AR)
- Provider Network Management Director ( Medicare Network Build) JR167138 **Preferred Location** : Commuting distance to the Little Rock, Arkansas office. **Hybrid ... is granted as required by law._ The **Provider Network Management Director ** develops the provider network in **Arkansas** through contract negotiations,… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... with regulatory, state, corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician committees including… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... belief system.** We believe wellness and sickness are both part of a lifelong partnership, and that everyone could...This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities.… more
- Humana (Miami Lakes, FL)
- …must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work ... **Become a part of our caring community and help us...The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** With the Medicare Finance Mid-West Regional team, you will support the Medicare ... Regional Finance Lead, who works closely with the Medicare Regional President and Market leadership. + Participate in the monthly close process, preparing financial… more
- Community Health Systems (La Follette, TN)
- …+ 1-2 years of experience in understanding the minimum requirements needed for Medicare billing, medical claims processing, or hospital revenue cycle operations ... **Job Summary** The Medicare Billing Specialist is responsible for performing timely...physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the… more
- CVS Health (St. Louis Park, MN)
- …Support community development, member education, and other activities as requested by the Director of Medicare Operations and as customer service demands allow. ... heart, each and every day. **Position Summary** As a Medicare Member Advocate supporting the Allina Health | Aetna...implementing solutions. + Conduct audit and monitoring activities as part of service oversight + Prepare and deliver training… more
- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following ... SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- CenterWell (Annapolis, MD)
- …a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. ... The Medical Director , Primary Care work assignments involve moderately complex to...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following ... SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Jefferson City, MO)
- …a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more