- Merck & Co. (North Wales, PA)
- Job DescriptionThe Executive Director , US Market Access Contracting will lead and oversee teams responsible for the implementation of our contract strategies with US ... Plans & PBMs, operating in the private and public markets (Medicaid, Medicare , Military & State), GPOs, Hospitals, Integrated Delivery Networks, Providers, Federal… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …Market Access accounts encompasses third party payers of Commercial, Medicaid and Medicare medical and prescription benefit plans. Customer channels and specific ... State Government entities and other Market Access organizations including physician/ medical groups, IDNs and IHNs. Relationships External relationships include… more
- Daiichi Sankyo, Inc. (Basking Ridge, NJ)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... association, think tank, or pharmaceutical company required- Expertise in Medicare , Medicaid, 340B, and/or commercial insurance market required- Strong knowledge… more
- CVS Health (Hartford, CT)
- …based (work at home) based anywhere in the US.**Responsibilities of this Medical Director role are related to Medicare Appeals.* Direct daily work on part C ... encumbrances* Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience.*… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Elevance Health (Richmond, VA)
- …office locations Work schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and implementing ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...clinical programs with specific medical condition focus for all lines of business enterprise… more
- CVS Health (Hartford, CT)
- …Enterprise Economics, the Strategy team supporting Medicare , as well as the core Medicare Finance team. This Executive Director will also: + Be a strategic ... affordable. Position Summary As a direct of the CFO, Medicare this role will work to ensure that the...Enterprise Economics, Clinical, Network, Related Parties (Shared Services) and Medical Economics to execute on growth priorities. + Partner… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …true colors to blue. Reporting to the SVP, Sales & Client Management, the Director , Group Medicare Sales, is an integral member of the leadership team-driving ... BCBSMA's purposeful re-entry into the Group Medicare Advantage Market. The role will have responsibility for Group Medicare Advantage and Medicare … more
- The Cigna Group (Columbus, OH)
- **Channel Marketing Director , Medicare Advantage - Hybrid** The Marketing Director will be responsible for leading the channel marketing team that supports ... the Cigna Medicare Advantage (MA) business. The MA business is a...line within the larger Cigna Government business. The Marketing Director will have accountability for local marketing efforts that… more
- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and ... the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional… more
- Elevance Health (Atlanta, GA)
- Business Strategy Plan Director - Medicare / Healthcare Consulting (JR119438) **Location** : Atlanta Preferred. Must reside within 50 miles/1 hour commute to a ... Cost of Care team** enables Elevance Health's focus on quality while reducing medical spend and overall costs to our member population and the health care… more
- UCLA Health (Los Angeles, CA)
- … Director of Pharmacy Benefits Management! Reporting directly to the Chief Medical Officer of Medicare Advantage, you'll spearhead the development and ... desired + Two or more years of experience in Medicare programs, preferred + Degree from an accredited school...throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David… more
- The Cigna Group (Morris Plains, NJ)
- The Director , Centene Account Management provides strategic, financial, clinical, relationship, and organizational leadership for the Medicare D and Exchange ... experience within the PBM or healthcare industry preferred; Experience in Medicare /Medicaid/Exchange market highly preferred. + Experience managing large books of… more
- CVS Health (Hartford, CT)
- …strategic leadership and oversight for financial planning and analysis for a Medicare Local Market by managing a team of financial analysts, coordinating budgeting ... budget presentations for senior leadership, and day-to-day ad-hoc analyses + Medicare Experience. EducationBachelor or similar work experience This is a hybrid… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As an important member of our Medicare Advantage team, you will provide strategic oversight and leadership for our Member and ... locations throughout metro Los Angeles. We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of… more
- AdventHealth (Altamonte Springs, FL)
- …and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital ... Reimbursement Analyst is responsible for preparing and filing the annual Medicare , Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal… more
- The Cigna Group (Bloomfield, CT)
- …- United States** **Summary** The Business Analytics Senior Advisor position within the Medicare Growth Analytics Team is an opportunity to provide leadership on our ... analytics strategy, to support our broader Medicare Growth team and provide actionable insights and analytics....to achieving its goals. Reporting to the Growth Analytics Director , this position will coordinate with cross functional teams… more
- CVS Health (Santa Ana, CA)
- …business. CVS Health/Aetna is working to transform the way California Medicare beneficiaries experience health care - improving quality, emphasizing whole-person ... Manager to support the growth of our industry leading Medicare business. This is a highly collaborative role in...the United States and will report to the Sales Director for Southern California. This is a career position… more
- UCLA Health (Los Angeles, CA)
- …Actuary, Director of Compliance, Director of Managed Care and Director of Medicare Advantage Operations regarding accounting for risk contracts. Provide ... and maintaining accounting and finance functions for the newly formed Medicare Advantage health plan. Key Responsibilities include: + Leading, developing, and… more
- Corewell Health (Grand Rapids, MI)
- …met. + Act as lead for expedited requests, gathering relevant information, working with Medical Director to determine if criteria is met. If expedited criteria ... payment, care management, authorizations, customer service interactions, pharmacy, Rx profiles, medical policies, and plan documents for all Medicare product… more
