- Elevance Health (St. Louis, MO)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...specific position is $125,118 to $214,488. Prorated based on part -time hours. Locations: Illinois, Washington DC, New York In… more
- Humana (Jefferson City, MO)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Jefferson City, MO)
- **Become a part of 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 Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Jefferson City, MO)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Jefferson City, MO)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Jefferson City, MO)
- **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
- Evolent (Jefferson City, MO)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Jefferson City, MO)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Jefferson City, MO)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us...high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality ... rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- Genesis Healthcare (Mount Vernon, MO)
- …**Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part -Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback ... Overview **Market Director Missouri** **Salaried Position** _St James, St Louis,...about making a meaningful difference and want to be part of the future of rehabilitation and wellness, Powerback… more
- Evolent (Jefferson City, MO)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
- GEHA (Lee's Summit, MO)
- …Oversight & Performance Management** + Day to day management of the commercial PBM and Medicare Part D / EGWP administrator relationships for the FEHB and PSHB ... pronounced GEHA) is a nonprofit member association that provides medical and dental benefits to more than two million...Health Benefits (PSHB) along with those for CMS for Medicare Part D / Employer Group Waiver… more
- ChenMed (St. Louis, MO)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... others, and driving a social media presence locally, as part of the core responsibilities for the role +...to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model,… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** At Humana, we are on a mission to provide an exceptional engineering experience for our ... and overall experience with our products. As the Associate Director of DevOps Platforms in the Enterprise Engineering Enablement...positive team culture that people want to be a part of. + You are detail oriented and have… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Director , Product Management Leads all phases of the product life cycle, from ... as a 5 member team of Agile coaches. The Director , IT Product Management works with relevant Humana stakeholders...and Associate Directors in developing a Product Mindset as part of the Product Operating Model *Establishes processes, standards,… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and ... diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data… more
- Prime Therapeutics (Jefferson City, MO)
- …and drives every decision we make. **Job Posting Title** Trade Client Relations Director - Remote **Job Description** The Trade Client Relations Director is ... responsible for the analysis, modeling and delivery of innovative pharmacy and medical rebate strategies and cost saving solutions to Prime's clients to ensure Prime… more
- Evolent (Jefferson City, MO)
- …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to solve ... impact on the organization and patient health. This role supports both medical cost management activities and business development efforts. **What You Will Be… more
- CenterWell (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The IPA Coding Leader manages a diverse team responsible for ensuring clinical documentation ... Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner… more