- Humana (Washington, DC)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... in accordance with Medicare and Humana policy. **Please note that this Medical Director position is non-benefitted, and compensated hourly * **Use your… more
- Humana (Washington, DC)
- **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
- Merck (Washington, DC)
- …with HSO MADs + Serves as a resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of US Medical Affairs on other ... **Job Description** + The Precision Medicine - Medical Affairs Director - Health Systems...research \#eligibleforERP **Required Skills:** Benefit Programs, Clinical Data, Clinical Pharmacy , Clinical Studies, Medical Affairs, Medical… more
- Grifols Shared Services North America, Inc (Washington, DC)
- …and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing ... access customer segment . Support reimbursement, coding, and coverage-related responsibilities for Medicare Part B, Centers for Medicare and Medicaid (CMS)… more
- Sunrise Senior Living (Silver Spring, MD)
- …**COMMUNITY NAME** Bedford Court **Job ID** 2025-233875 **JOB OVERVIEW** The Director of Nursing Services is responsible for providing leadership and management ... and implements plans of correction for concerns and issues identified by pharmacy consultants. + Reviews and develops plans of correction with interdisciplinary team… more
- Bristol Myers Squibb (Washington, DC)
- …and conditions of the applicable plans then in effect and may include the following: Medical , pharmacy , dental and vision care. Wellbeing support such as the BMS ... personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Senior Director , Policy Research will lead BMS's US policy research initiatives… more
- AmeriHealth Caritas (Washington, DC)
- … management leadership is required. Managed care organization leadership experience as a Medical Director or CMO is preferred. + Demonstrated ability to lead ... **Role Overview:** The Market Chief Medical Officer (CMO) reports directly to the Market...Experience working with multiple business product lines, ie, Medicaid, Medicare , ACA/Exchange. + Experience and/or knowledge of the health… more
- Sunrise Senior Living (Silver Spring, MD)
- …follows Resident Centered Care model. + Assists with case management of both Medicare and non- Medicare guests/residents as needed. + Participates in the Care ... guests/residents charts. + Completes Incident Reports and reports to Director of Nursing Services (DNS). + Reviews, updates and...initials, date and time 'noted' and date faxed to pharmacy . + Demonstrates and knowledgeable of the Six (6)… more
- Immigration and Customs Enforcement (Washington, DC)
- …of understanding with IHSC. HPMU also works jointly with IHSC stakeholders: pharmacy ; dental; Behavioral Health Unit; Field Medical Coordination Unit; and ... Border Patrol, third party administrator and off-site community providers) regarding medical claims processes, trainings, and principles. Provides guidance to the… more