- CVS Health (Springfield, IL)
- …can be located anywhere in the United States. In this role as Medical Director MPO ( Medical Policy & Operations) you will be responsible for providing ... focused medical care with a focus on clinical and payment policy . This Medical Director provides subject matter expertise to provide clinical support and… more
- Humana (Springfield, IL)
- **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...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This is a remote based, work ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Springfield, IL)
- …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...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- CVS Health (Springfield, IL)
- …the Medical Director role you will + Provide oversight for medical policy implementation. + You will participate in the development, implementation, and ... ensuring timely and consistent responses to members and providers. As a Medical Director you will + Focus primarily on overseeing utilization review / quality… more
- Centene Corporation (Springfield, IL)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Veterans Affairs, Veterans Health Administration (Springfield, IL)
- …payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. ... clinical service chiefs but provide a full range of medical services to patients who are assigned to Ambulatory...Education Officer (DEO), the Internal Medicine Residency Program Site Director and the Site Coordinator for the Internal Medicine… more
- Sumitomo Pharma (Springfield, IL)
- …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... for SMPA investigational and commercial products. The incumbent will provide medical safety support for safety signal management throughout product lifecycle… more
- Merck (Springfield, IL)
- **Job Description** **Role Summary:** + The Regional Director Medical Affairs (RDMA) is responsible for driving execution of scientific & medical affairs ... cross-functional teams, including regional Commercial, Center of Real-World Evidence (CORE), Policy and Market Access. They engage with their network of scientific… more
- Evolent (Springfield, IL)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... to improve decision-making and care outcomes. + Assist in **research, policy interpretation, and guideline development** to refine the delivery of cardiology… more
- Highmark Health (Springfield, IL)
- …most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical ... members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- We are seeking a Senior Director , Federal Government Affairs to lead our US federal government engagement in Washington, DC. This position reports to the Vice ... President, Government Affairs & Public Policy , within the Corporate Affairs function. As the strategic...member of the Government Affairs Leadership Team, the Senior Director of the Federal Government Affairs will play an… more
- Bausch + Lomb (Springfield, IL)
- …to continue leading the advancement of eye health in the future. **Objectives** The Director /Sr. Director is a member of the R&D Global Portfolio and Project ... Project Management Leadership Team (PMLT) member and drives process and policy improvements and cross Business Unit (BU) collaborations and standardization. The… more
- Humana (Springfield, IL)
- …community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid builds strategies for development, ... clinical practices and processes for clinical community within the enterprise. The Director , Clinical Strategy and Practice requires an in-depth understanding of how… more
- CenterWell (Springfield, IL)
- …of our caring community and help us put health first** The **Branch Director ** is accountable for managing the day-to-day branch operations to ensure the following: ... of key performance indicators, and people management/development. The Branch Director supervises the branch/clinical staff. Direct responsibility of ensuring the… more
- Humana (Springfield, IL)
- …experience for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals), you will be accountable for ... starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits +...or DSL Connection in Exceptions, Section 7.0 in this policy .) + Humana will not pay for or reimburse… more
- Humana (Springfield, IL)
- …our caring community and help us put health first** The Associate Director , Software Engineering leads software development application team based on business ... requirements. The Associate Director , Software Engineering requires a solid understanding of how...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more