- Evolent (Nashville, TN)
- …Evolent for 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 ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD… more
- Evolent (Nashville, TN)
- …patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD /DO/MBBS Degree + Current, unrestricted… more
- Evolent (Nashville, TN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD… more
- Evolent (Nashville, TN)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the ... Clinical Reviewers. . Ensures documentation of all communications with medical office staff and/or MD provider is...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Nashville, TN)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Nashville, TN)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... expedited appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is...utilization management while working in conjunction with the Senior Medical Director . May assist the Senior … more
- Evolent (Nashville, TN)
- …health outcomes and a more connected care journey. We are hiring for a Managing Director , Actuarial Services to join our Finance Team. The candidate selected ... credentials **(Required)** + 10+ years of experience working in a medical economics-related field **(Required)** + Exceptionally strong analytical abilities,… more
- The Cigna Group (Franklin, TN)
- The Account Management Managing Director , Market Coalitions, is a role with unique responsibilities and requires a dual focus in the approach to our clients. The ... strategies through our consultant led coalitions. Additionally, leadership is responsible for managing the portfolio of PBM employer clients and will lead a team… more
- CenterWell (Nashville, TN)
- …a part of our caring community and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical leadership position ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… more
- Merck (Nashville, TN)
- …investigator-sponsored research studies. The RMSD serves as a role model for other field medical team members in ways that include on-boarding and/or sharing ... **Job Description** **Position Responsibilities** + The Regional Medical Scientific Director (RMSD) is a...the foundational elements of diversity + Consistent adherence to field and corporate policies and Global Medical … more
- Travelers Insurance Company (Nashville, TN)
- …**What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical ... for Travelers: Develop strategies and direction to advance Travelers medical capabilities to keep Travelers at the leading edge...guidance, support and direction as needed to the Claim Field organization. + Provide input into to claim practices,… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- **Position Summary:** The Director GVE Operations oversee and coordinates projects within the department to ensure alignment with organizational goals. This role is ... other integrated data generation initiatives. This position reports to the Senior Director , Global Integrated Evidence & Innovation Operations and can be based in… more
- HCA Healthcare (Nashville, TN)
- …position within HCA Healthcare's Risk & Insurance department reporting directly to the Managing Director of Property Claims. You will support the Insurance ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Community Health Systems (Franklin, TN)
- …appropriate coding references for CHS hospitals via scanned, electronic and hybrid medical records. Based on review findings, writes appeal letters to include ... reason for the denial and appeal status. + Consults with Coordinator and/or Director , Coding Denials and Appeals during any audit discrepancies. + Attends coding… more
- Wolters Kluwer (Nashville, TN)
- …satisfaction. **Work Arrangement** : 100% Remote position. You will report to the Associate Director , Field Sales * CPESG | WK Audit & Assurance, and work ... under the leadership of the Director , Sales, CP & ESG TeamMate * CPESG |...needs and balance your work and personal life, including: Medical , Dental, & Vision Plans, 401(k), FSA/HSA, Commuter Benefits,… more
- Community Health Systems (Franklin, TN)
- …required + Associate Degree in Healthcare Administration, Business, or a related field preferred + 2-4 years of experience in credentialing or provider enrollment ... required + Experience supporting hospital credentialing programs or medical staff offices preferred **Knowledge, Skills and Abilities** + Strong understanding of… more