- Elevance Health (Columbus, OH)
- …you a check, or ask you for payment as part of consideration for employment. ** Medicare Duals Management Director - Ohio** + Job Family: BUS > Strategy, Planning ... 22, 2024 + Reference: JR111940 **Location:** + OH, COLUMBUS **Description** ** Medicare Duals Management Director -Ohio** **Location** : This position will… more
- Elevance Health (Seattle, WA)
- …you a check, or ask you for payment as part of consideration for employment. ** Medicare Duals Management Director -West** + Job Family: BUS > Strategy, Planning & ... GRAND PRAIRIE + CO, DENVER + WA, SEATTLE **Description** ** Medicare Duals Management Director -West** **Grand Prairie, TX,...**Location** : This position will work a hybrid model ( remote and office). The ideal candidate will live within… more
- Magellan Health Services (Boise, ID)
- …After Hours coverage may be required. General Job Information Title Medical Director (Behavioral Health) - Idaho- Remote Grade 36 Work Experience - Required ... the health plan(s) for all lines of business (Medicaid, Medicare , and Commercial) and implements programs to support this...activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May… more
- The Cigna Group (Birmingham, AL)
- **_LOCATION: Hybrid/ Remote position aligned to the Tri-South Alabama/Mississippi Market. Must live in either Alabama or Mississippi._** The **Manager, Provider ... member of the Provider Contracting Team and reports to the Provider Contracting Director . This role assists in developing the strategic direction and management of… more
- Boehringer Ingelheim (Ridgefield, CT)
- …and benefit programs reflect Boehringer Ingelheim's high regard for our employees. The Director , MSL oversees the TA MSL team and Sr AD MSL leaders, through ... in demonstrable outcomes. In partnership with peer MSL Directors, the Director , MSL drives ongoing process improvement, challenging inefficiencies, recommending new… more
- Henry Ford Health System (Troy, MI)
- …, you will play a crucial role in shaping and overseeing HAP's Medicare financials analysis, medical expense budgeting, and coordination with consulting ... Plan (HAP) is seeking a dynamic leader as the Director , Actuarial and Healthcare Analytics. As the Director...actuaries. This is a true leader who will own Medicare strategy, lead an exceptional team, and drive profitability… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …care to our clients. BAYADA Home Health Care is currently seeking an experienced Director of Compliance. The Compliance Director , is responsible for oversight of ... entities as needed in collaboration with the Chief Compliance Officer, Division Director , Compliance, and the Legal Services Office as needed. + Interpret relevant… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- PharmD/RPH required- REMOTE **Job Description ... Summary** Responsible for support and development of Medical Pharmacy program strategy as part of the Medical Pharmacy Business Development team. Responsible for… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Associate Director , SIEM & Detection Engineering oversees the SIEM engineering, alerting and detection ... well as other enterprise information security teams. Job Description The **Associate Director , SIEM & Detection Engineering** role is responsible for the strategic… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Associate Director of the Tier 1 SOC is a critical role in our organization, responsible for ... level of technical expertise, strategic thinking, and leadership abilities. The Associate Director will oversee the tier 1 SOC (MSSP) providing 24x7x365 coverage,… more
- Martin's Point Health Care (Portland, ME)
- …of Medicare Risk Adjustment initiatives and operations. The Senior Director is also responsible for all aspects of the decision-making and implementation ... Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan...of medical record coding reviews and coding policies for the… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote . The role requires a broad knowledge and focus ... utilization management, industry benchmarks, demonstrated regulatory requirement experience and medical necessity criteria. The role requires the ability to… more
- Humana (Columbus, OH)
- **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
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director , Privacy and Security directs and manages Commonwealth Care Alliance's (CCA) efforts to ensure compliance with ... + Works closely with IT Security, members of the electronic medical record implementation/informatics team, and other information technology personnel to ensure… more
- VIP Care (Tampa, FL)
- Summary/Objective: The Senior Medical Director is responsible for leading efforts to develop and implement medical management and performance improvement ... strategies to ensure success in our existing ( Medicare Advantage) as well as net new LOBs. They...utilization and provide better health for patients. The Senior Medical Director would also leverage their entrepreneurial… more
- Medical Mutual of Ohio (Brooklyn, OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. The Clinical Operational… more
- Astellas Pharma (Northbrook, IL)
- ** Medical Director Oncology, Medical Affairs** Do you want to be part of an inclusive team that works to develop innovative therapies for patients? Every ... visit our website at www.astellas.com. Astellas is announcing a ** Medical Director Oncology, Medical Affairs,... Affairs, United States (MA-US)** opportunity in Northbrook, IL. Remote work from certain states may be permitted in… more
- WellSense (Boston, MA)
- …in collaboration with the Senior Director of Strategy and Operations, the BH Medical Director , the Senior Vice President of BH to determine the most ... Senior Director of BH Clinical Programs WellSense Health Plan...company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25… more
- MetroLink (Los Angeles, CA)
- Director , Design (Limited Term) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4458277) Apply Director , Design (Limited Term) Salary ... Annually Location California 91767, CA Job Type At Will Full Time Remote Employment Flexible/Hybrid Job Number 23-2400105 Department Standards & Design Opening Date… more
- MetroLink (Los Angeles, CA)
- Director , Program Management Oversight Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4290792) Apply Director , Program Management Oversight ... Annually Location California 91767, CA Job Type At Will Full Time Remote Employment Flexible/Hybrid Job Number 23-2400087 Department Program Management Opening Date… more