- CVS Health (Hartford, CT)
- …of covered benefits in the Commercial and Medicare environment with a focus Medicare policy., This Medical Director provides subject matter expertise in ... day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a… more
- Humana (Hartford, CT)
- **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
- CVS Health (Hartford, CT)
- …based (work at home) based anywhere in the US. Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part C ... * Board Certified in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience. *… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal ... candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a strong… more
- Humana (Hartford, CT)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Evolent (Hartford, CT)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Hartford, CT)
- …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 (Hartford, CT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... 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 (Hartford, CT)
- …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 utilization management ... 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
- Evolent (Hartford, CT)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... 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
- Evolent (Hartford, CT)
- …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
- Athena Health Care Systems (Middletown, CT)
- We are hiring an MDS Director to join our dynamic care team at Wadsworth Glen Health Care and Rehabilitation Center in Middletown! Wadsworth Glen is a 102-bed ... you to grow within the company. As the MDS Director , you plan, organize, and direct the MDS process...resident care plans through clinical assessment, review of resident's medical history, personal interviews, and completion of MDS reports.… more
- Bristol Myers Squibb (New Haven, CT)
- …bill therapy reimbursement experience including: + Coverage, coding, billing and payment + Medicare (NCD, IPPS, OPPS, 340B, etc.) + Medical policy, managed care ... personal lives. Read more: careers.bms.com/working-with-us . **Summary:** The Associate Director , Cellular Therapy Market Access is responsible for executing access… more
- Hartford HealthCare (Farmington, CT)
- …and Vascular, Orthopedics and Tallwood Urology & Kidney. Position Summary: The Director of Professional Services Coding will provide system wide leadership and ... and revenue integrity procedures that directly impact the organizations' revenue cycle. The Director serves as a key resource for best practices in diagnostic and… more
- National Health Care Associates (Wallingford, CT)
- …Driven **What You Will Do:** You will function primarily as a Fulltime Interim Director of Nursing and/or advisor, in any Connecticut center owned and operated by ... of 3 months. When you're not acting as a Director of Nursing, you're working with the regional clinical...state of CT + CPR certified + Understanding of Medicare guidelines **What We Offer:** An engaging and supportive… more
- National Health Care Associates (East Hartford, CT)
- …understanding of Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements + Interest in the nursing needs of the aged and the ... We invite you to join our team! **-** **MDS Director MUST HAVE EXPERIENCE** **$1500 Sign on bonus!** **What...Sign on bonus!** **What You'll Do:** As an MDS Director , you will manage the Minimum Data Set (MDS)… more
- Elevance Health (Wallingford, CT)
- …budgeting, and implementing initiatives that enhance operational efficiency across Commercial, Medicare , and Medicaid markets. The Director plays a critical ... **Strategy & Program Development Director - Payment Integrity Strategy & Planning** **Location:**...and drive practical strategies as we seek to reduce medical costs is preferred. + Knowledge and experience in… more