- Elevance Health (Wallingford, CT)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...specific position is $125,118 to $214,488. Prorated based on part -time hours. Locations: Illinois, Washington DC, New York In… more
- CVS Health (Hartford, CT)
- …US.** Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary on the non-regulated appeals team, ... encumbrances * Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience.… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Hartford, CT)
- **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 and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Evolent (Hartford, CT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Hartford, CT)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Hartford, CT)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us...high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality ... rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- Athena Health Care Systems (Middletown, CT)
- We are hiring an MDS Director to join our dynamic care team at Wadsworth Glen Health Care and Rehabilitation Center in Middletown! Wadsworth Glen is a 102-bed ... you to grow within the company. As the MDS Director , you plan, organize, and direct the MDS process...resident care plans through clinical assessment, review of resident's medical history, personal interviews, and completion of MDS reports.… more
- Evolent (Hartford, CT)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
- Hartford HealthCare (Norwich, CT)
- …we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. Position Summary: The Director ... oversight for the overall operations of the Care Coordination department. The Director is responsible for the development and implementation of the case management… more
- Arvinas (New Haven, CT)
- …providers/organizations, with a strong preference for knowledge of national and regional payers, Medicare Part D, and Medicaid. + National payer experience and ... Summary** As an important member of the Arvinas Market Access Team, the ** Director , Payer Accounts** will be a key contributor to a strong National Accounts… more
- Hartford HealthCare (Farmington, CT)
- …do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. Hartford HealthCare's unified culture ... and Vascular, Orthopedics and Tallwood Urology & Kidney. Position Summary: The Director of Professional Services Coding will provide system wide leadership and… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** At Humana, we are on a mission to provide an exceptional engineering experience for our ... and overall experience with our products. As the Associate Director of DevOps Platforms in the Enterprise Engineering Enablement...positive team culture that people want to be a part of. + You are detail oriented and have… more
- Bayer (Stamford, CT)
- …diverse minds to make a real difference, there's only one choice.** **Associate Director - Field Reimbursement - Oncology - (Northeast USA)** **Associate Director ... HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Director , Product Management Leads all phases of the product life cycle, from ... as a 5 member team of Agile coaches. The Director , IT Product Management works with relevant Humana stakeholders...and Associate Directors in developing a Product Mindset as part of the Product Operating Model *Establishes processes, standards,… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and ... diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data… more