- Fresenius Medical Center (Franklin, TN)
- … programs (HMOs, PPOs, POS, etc). Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate ... financial effect, cost benefit and utilization. + Negotiates contractual relationships with managed care organizations and other third party payors as needed.… more
- Humana (Nashville, TN)
- …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed ... help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care ...medical management review organization, such as Medicare Advantage and managed Medicaid + Experience with national guidelines such as… more
- Humana (Nashville, TN)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... management. The clinical scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external… more
- Humana (Nashville, TN)
- …adapt and the courage to innovate. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid. ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- CenterWell (Nashville, TN)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
- Cardinal Health (Nashville, TN)
- …covering both strategic hunting and complex account management with payers and managed care organizations. By combining rigorous performance management with ... and products company headquartered in Dublin, OH. The _National Director of Sales, Market Access_ serves as the dynamic...seasoned expertise in the managed care industry, this leader translates the… more
- Option Care Health (Nashville, TN)
- …IG to include clinical, market, and payer dynamics + Knowledge of reimbursement, managed care , and marketing **Basic Qualifications** + Proven record of ... no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and...brightest talent in healthcare. **Job Description Summary:** The National Director IG Business Development role will be responsible for… more
- Humana (Nashville, TN)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... 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 (Nashville, TN)
- …management, and acute inpatient rehabilitation. Preferred Qualifications + Knowledge of the managed care industry including Medicare Advantage, Managed ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Nashville, TN)
- …on average) Eastern Time Zone hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... 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
- Cardinal Health (Nashville, TN)
- …OH. The _Director of Business Development, Market Access_ is a seasoned managed care executive and strategic individual contributor responsible for developing ... contract lifecycle. + Serve as the external subject matter expert on managed care , value-based payment methodologies, and population health trends, leveraging… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a **Portfolio Director of Surgery Service Line** ? At HealthTrust, you come first. HCA Healthcare has ... and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +...a difference. We are looking for a dedicated Portfolio Director - Surgery like you to be a part… more
- Humana (Nashville, TN)
- …skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + ... and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims...serve to achieve their best health - delivering the care and service they need, when they need it.… more
- Compass Group, North America (Murfreesboro, TN)
- TouchPoint **Salary:** **Other Forms of Compensation:** **Reports to: Systems Director , Food & Nutrition** **We are offering a $10,000 sign on bonus and relocation ... best outcomes to our clients. **Job Summary** **The Sr. Director of Dining Services** is responsible for overseeing the...healthcare food service management experience preferably in an acute care hospital setting + Five years of proven leadership… more
- Cardinal Health (Nashville, TN)
- …mission is to empower community oncology practices to deliver patient-centered cancer care . Navista, a Cardinal Health company, is an oncology practice alliance ... team is passionate about helping oncology practices navigate the future. The Director of Practice and Network Strategy will be responsible for shaping and… more
- BrightSpring Health Services (Nashville, TN)
- Our Company BrightSpring Health Services Overview The Sr. Director is responsible for management of the Revenue Cycle organization and process to ensure the timely ... on all billings for the rehabilitation business unit. The Sr Director 's responsibilities include identifying reimbursement issues, ensuring that claims, denials, and… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- …facility. Effectively managing key relationships with facility therapists, physicians, key staff, managed care providers, rehab suppliers, and other key referral ... Assistant Director of Rehabilitation (ADOR) PT/OT/PTA/COTA/SLP The Gallatin Center...the elderly and demonstrate the facility's approach to interdisciplinary care . This includes but is not limited to oversight… more
- Highmark Health (Nashville, TN)
- …Doctor of Pharmacy degree + Active pharmacist license + 4 years of experience in managed care pharmacy + 2 years of clinical account management experience in ... Medicare as part of the 4 year managed care experience + 2 years of experience analyzing pharmaceutical cost of care data **Substitutions** + None… more
- Vanderbilt University Medical Center (Nashville, TN)
- …submission of pediatric transplant data as required by regulatory agencies and managed care companies. TECHNICAL CAPABILITIES * Continuous Process Improvement ... at a global crossroads of teaching, discovery, and patient care , VUMC is a community of individuals who come...the VUMC Transplant Center and the Pediatric Transplant Medical Director to establish and grow both internal and external… more
- Sedgwick (Nashville, TN)
- …: **The ideal candidate would have a workers comp background in claims and/or managed care . Preferred experience in: client services, clinical operations, and or ... workers comp claims** . To determine account management strategies related to client service plans; to be responsible for retention of existing clients, customer satisfaction, revenue growth, client surveys, and new business. Understanding our specialty… more