- Elevance Health (Nashville, TN)
- …Health office locations Work schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...implementing clinical programs with specific medical condition focus for all lines of business enterprise… more
- Humana (Nashville, TN)
- **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
- CenterWell (Nashville, TN)
- …part of our caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic pharmacy leader responsible for developing, ... Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: +...(SME) and clinical liaison to the national clinical leadership (including Chief Medical Officer, Complex… more
- Vanderbilt University Medical Center (Nashville, TN)
- …preeminent programs in patient care, education, and research. **Organization:** VICC - Clinical Trials 40 **Job Summary:** The Assistant Director supervises a ... **Discover Vanderbilt University Medical Center:** Located in Nashville, Tennessee, and operating...eg, hiring, promotion and termination. Required Qualifications: * Direct Clinical trial budgeting experience * Oncology experience * Understanding… more
- Humana (Nashville, TN)
- **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...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Prime Therapeutics (Nashville, TN)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description ... Medical Pharmacy clients and potential new clients. Required to serve as a Medical Pharmacy clinical resource throughout the organization and support all … more
- Humana (Nashville, TN)
- …our caring community and help us put health first** The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new ... and work is performed without direction. The Behavioral Health Medical Director actively uses their medical...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Elevance Health (Nashville, TN)
- …May be responsible for an entire clinical program and/or independently performs clinical reviews. + The Medical Director typically has program management ... miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration...Director Associates. May be responsible for an entire clinical program. How you will make an impact: +… more
- HCA Healthcare (Nashville, TN)
- …chief nursing officers (CNO) and other hospital/ASC, board of trustee and medical staff leaders regarding clinical performance improvement and foundational ... * Designs and presents educational programs for HCA Healthcare hospital/ASC and medical staff leaders regarding requirements of clinical performance improvement… more
- HCA Healthcare (Nashville, TN)
- …Technology is responsible for all simulation- and technology-based education within the Clinical Education Service Line. The Director of Simulation and ... an organization that invests in you as a Corporate Director Simulation Technology? At HCA Healthcare, you come first....colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Humana (Nashville, TN)
- …our caring community and help us put health first** Are you passionate about the Medicare population and looking for a role in healthcare leadership with a focus on ... highly motivated and self-driven individuals to join our team. As an Associate Director , Partner Channel Inside Sales, you will support Humana's production goals by… more
- CenterWell (Nashville, TN)
- …in Medicare /seniors * Demonstrated ability to work collaboratively with clinical and operational leaders across a complex health care organization. * Knowledge ... a part of our caring community and help us put health first** **National** ** Director of Transitional Care and High-Risk Patient Management** The Director of… more
- Cardinal Health (Nashville, TN)
- The Director , Channel Development Strategy- Diabetes for Cardinal Health's at-Home Solutions is responsible for providing enhanced relationship management for ... supply chains across public and private sectors, specifically including Medicare DMEPOS reimbursement landscape. + Comprehensive communication and negotiating skills… more
- Signature Healthcare (Nashville, TN)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... compliance program is ongoing in accordance with company policies, standards of clinical care that meet state/federal regulations to promote excellence in care and… more
- Aveanna (Franklin, TN)
- …the direction and guidance of the Executive Director and Medical Director to provide supervision of all clinical staff working to provide and document ... Hospice RN Clinical Manager with 10K Sign on Bonus ApplyRefer...that services are delivered according to licensing guidelines, professional medical standards and agency policies and procedures. ** This… more
- Prime Therapeutics (Nashville, TN)
- …of utilization management decisions. + On a requested basis, may function as Medical Director for select health plans or regions, assuming overall accountability ... as needed to discuss cases and problems. + Utilizes medical / clinical review guidelines and parameters to assure... Affairs. + Other duties as assigned. **Responsibilities** + Medicare Part D experience preferred. + Doctor of Medicine… more
- The Cigna Group (Nashville, TN)
- …research and provide a written detailed clinical summary for the Plan Medical Director . + Determine whether additional pre service, appeal or grievance ... **Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst**...appeals will include requests for decisions regarding denials of medical services as well as Part B drugs. The… more
- Highmark Health (Nashville, TN)
- …+ Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures to drive ... as an adjunct to health coaching. If acting in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case… more
- CenterWell (Smyrna, TN)
- … medical expertise with the care team through daily huddles. + Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- Gentiva (Nashville, TN)
- … equipment as indicated. + Communicate clinical findings to the Palliative Medical Director as needed, but no less than bi-weekly. Re-assess effectiveness of ... Provides diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director (if required under State law). **As a Nurse… more