- Highmark Health (Jefferson City, MO)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care delivery ... clinical leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP to insure standards of care are… more
- Highmark Health (Jefferson City, MO)
- …the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In ... for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure… more
- Humana (Jefferson City, MO)
- …Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information This is a remote position \#LI- Remote **Scheduled Weekly ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Jefferson City, MO)
- …Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay ... 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… more
- Highmark Health (Jefferson City, MO)
- …Improvement + Analytical and Logical Reasoning/Thinking + Regulatory Compliance + Communication Skills + Leadership/Leading Change **EDUCATION** **Required** ... 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote -based Teaches / trains others Occasionally Travel from the office to… more
- Highmark Health (Jefferson City, MO)
- …25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote -based Teaches / trains others Occasionally Travel from the office to ... must comply with both the Health Insurance Portability Accountability Act of 1996 ( HIPAA ) as described in the Notice of Privacy Practices and Privacy Policies and… more
- Highmark Health (Jefferson City, MO)
- …strategy and objective setting. Supports the business partner, interfaces at the Director and Manager levels of the company, provides procurement services and ... such as supplier relationship management, spend performance management, demand and compliance management, internal spend and external market analysis, and category… more
- Highmark Health (Jefferson City, MO)
- …deliver measurable business outcomes. This role will report directly to the Director of MarTech and Operations and lead day-to-day optimization, automation and ... management, digital, research, media, in-house agency leaders, IT, data analytics, compliance , and procurement to ensure a harmonious MarTech ecosystem. **Process:**… more
- Wolters Kluwer (Jefferson City, MO)
- **Specialized Consulting Manager - Pharmacy** Wolters Kluwer R0043371 **LOCATION:** Remote US (Hybrid - 8 days per month if within 50 miles of an office listed on ... This is an individual contributor role. You will report to the Associate Director , Specialized Pharmacy Consulting. **DUTIES** You will contribute to the success of… more