- Elevance Health (Waukesha, WI)
- **Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... The ideal candidate has experience working in leading healthcare payer claims / revenue cycle management (RCM) organizations, with specific understanding… more
- Molina Healthcare (Green Bay, WI)
- …including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery, ... claims , COB and DRG/RCC pricing), and IPA. 2 years supervisory/ management experience with appeals/grievance processing within a managed care setting. **Preferred… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
- Humana (Madison, WI)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... 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 (Madison, WI)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... value based care, population health, or disease or care management . **Responsibilities** The Medical Director provides medical interpretation and… more
- Humana (Madison, WI)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... 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
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- **Position Summary:** The Associate Director of Global Medical Affairs Omnichannel will be responsible for developing and leading the omnichannel strategy for ... Global Medical Affairs across all therapeutic areas and brands. This...aligning with CoE training efforts + **Performance & Risk Management :** + Provide regular updates on the performance and… more
- Centene Corporation (Madison, WI)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Humana (Madison, WI)
- …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Molina Healthcare (WI)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …The Associate Director is responsible for the design, execution, and management of multiple market research engagements. In addition, the Associate Director ... **Job Summary** The Associate Director of Brand Analytics role for the ecosystem...that deliver exceptional results + Have strong analytical, project management , fiscal management and decision-making skills Have… more
- Humana (Madison, WI)
- …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...with cross-functional teams, including Brand Marketing, Sales, Patient Access, Medical Affairs, and Regulatory, to integrate pharmacy operations seamlessly… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- 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 ... leader, and a member of the Government Affairs Leadership Team, the Senior Director of the Federal Government Affairs will play an integral role in developing… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …patient outcomes and optimize business processes. **About This Role** The Director , Cloud Operations is responsible for managing, operating, and enhancing our ... and performance in alignment with our growth objectives. The Director will oversee daily operational functions, including infrastructure monitoring, incident… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …markets innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health As ... a Director , Quantitative Pharmacology, **Clinical Pharmacology,** you will oversee all...on activities related to formulation, development, assay development, sample management , Pharmacogenomics (PGx) and biomarker strategy development. + Train… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …in both in-line brand stewardship and upcoming product launches, the Associate Director , Channel Strategy and Patient Affordability will serve as a key strategic ... external pressures (eg, 340B, patient leakage) and internal shifts (eg, LOE management , innovative distribution models), this role will be critical in anticipating… more
- Sedgwick (Madison, WI)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Data Tools, Governance and Architecture **PRIMARY PURPOSE OF THE ROLE:** This ... approaches with the overall enterprise architecture and minimize costs. The Tech Director will collaborate closely with the Enterprise Architecture , Security , DBA… more