- e CancerCare (Nashville, TN)
- …with Health Insurance companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible ... aligns negotiation with strategy. Essential Functions: In collaboration with the Director of Managed Care , negotiate and manage assigned contracts, including… more
- Randstad US (Nashville, TN)
- …at least five of which were in a senior leadership position. **OVERVIEW** The Director is responsible for the overall success of each assigned Managed In-House ... efficiencies, new business development and client relations. In addition, the Director will support Cella Inc. with consulting, training, networking and business… more
- Prime Therapeutics (Nashville, TN)
- …and drives every decision we make. **Job Posting Title** Clinical Oncology Pharmacist- Managed Care Oncology Experience required - REMOTE **Job Description** The ... oncology institution, practice or hospice + Experience working in managed care , health plans or PBM +...to adjust focus Reporting Structure: + Reports to Senior Director or Director in the Medical Specialty… more
- Humana (Nashville, TN)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Nashville, TN)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Nashville, TN)
- …services such as inpatient rehabilitation. **Preferred Qualifications:** + Knowledge of the managed care industry including Medicare Advantage, Managed ... community and help us put health first** The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new delivery models.… more
- Valvoline Global (Nashville, TN)
- …product innovation and sustainable business solutions. Our corporate values of ** care ** , **integrity** , **passion** , and **excellence** shape everything we ... Global, you join a culture that is committed to: treating all people with care , operating with integrity, striving for excellence in everything we do, and showing… more
- HCA Healthcare (Nashville, TN)
- …and authorization of level of care . + Offers input on managed care contracting issues, best demonstrated practices, process improvement and utilization ... of over 180 hospitals and about 2,000 sites of care in 21 states and the United Kingdom. We...the United Kingdom. We are looking for a Medical Director for our Work from Home team where excellence… more
- HCA Healthcare (Nashville, TN)
- …Do you have the career opportunities as a Laboratory Portfolio and Services Director you want with your current employer? We have an exciting opportunity for ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Portfolio Director ? At HealthTrust, you come first. HCA Healthcare has committed up to $300 million in ... and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +...make a difference. We are looking for a dedicated Director Portfolio like you to be a part of… more
- Prime Therapeutics (Nashville, TN)
- …meetings and for publication acceptance. **Responsibilities** + 7+ years of pharmacy, managed care and pharmaceutical industry experience. + At least 1-2 ... Strong interpersonal, consultation, organizational, tracking and follow-up skills. + Pharmacy, Managed Care , Pharmaceutical Industry experience. + Ability to… more
- Prime Therapeutics (Nashville, TN)
- …**Responsibilities** + Knowledge of and experience with Medicaid pharmacy practice, managed care pharmacy practice, and/or pharmaceutical rebate contracting. + ... drives every decision we make. **Job Posting Title** Sr Director , Value Based Pricing - Preferably on the West...Pharmacy (PharmD) required. + 10+ years' professional experience in managed care and/or Medicaid. + 5+ years'… more
- Vanderbilt University Medical Center (Nashville, TN)
- …including proforma financial analysis, development of internal pricing models, supporting managed care rate negotiations and process improvement activities ... + Ability to evaluate third party payor reimbursement in partnership with managed care professionals to support strategic initiatives. + Experience working… more
- CenterWell (Nashville, TN)
- …Conviva/CenterWell market location(s) + Experience working in a value-based care , senior care , and/or Medicare managed care **Workstyle** This is a ... our caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic pharmacy leader responsible for developing, implementing,… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …an understanding of MDS requirements related to varied payers including Medicare, Managed Care and Medicaid + Ensures timely electronic submission of ... as in-house case manager by considering all aspects of the residents care and coordinating services with physicians, families, third party payers and facility… more
- Compass Group, North America (Nashville, TN)
- …our clients. Job Summary: Based at St. Thomas Midtown Hospital, the System Director of Dining Services provides operational oversight of all food and nutrition ... 8 Directors and over 250 Associates will roll up to this position. As the System Director , you will report to a TouchPoint Vice President with a dotted line to our… more
- Prime Therapeutics (Nashville, TN)
- …assigned. **Responsibilities** Minimum 10 years experience in product development preferably within the managed care industry plus 5+ or more years of experience ... passion and drives every decision we make. **Job Posting Title** Senior Director , Product Development & Innovation **Job Description Summary** Provide leadership in… more
- Humana (Nashville, TN)
- …skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + ... and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims...serve to achieve their best health - delivering the care and service they need, when they need it.… more
- Evolent Health (Nashville, TN)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial utilizes and develops analytical tools to solve… more
- Elevance Health (Nashville, TN)
- …background. Preferred Skills, Capabilities and Experiences: + Consulting experience and/or MBA. + Managed care experience improving cost of care trend. + ... schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and implementing...LOB, leaders, and other clinical initiatives including cost of care . This role will work on Cost of … more