- Humana (Baton Rouge, LA)
- **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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Albany, NY)
- …put health first** Humana's Marketing organization is seeking an Associate Director , Product Marketing to lead the go-to-market, positioning, and member-focused ... campaigns for our Medicaid lines of business. You will craft the product...on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other...7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical… more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Indiana Medicaid Market CFO analyzes and forecasts financial, economic, and other data to provide ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Evolent (Phoenix, AZ)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Centene Corporation (Indianapolis, IN)
- …competitive benefits including a fresh perspective on workplace flexibility. **We're Hiring: Remote Medical Directors** Centene Corporation is a leading provider ... quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical … more
- AbbVie (Mettawa, IL)
- … of Federal Contracting, Regional Director of Federal Accounts, and Director of Medicaid Contracting, including their respective AEs, to enhance account ... that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a...contracting, retention, and pull-through performance across the DoD, VA, Medicaid , IHS and Kaiser channels. + Manage Channel Directors… more
- Option Care Health (Madison, WI)
- …and brightest talent in healthcare. **Job Description Summary:** The Specialty Sales Director will develop and implement the Specialty business sales plan that ... geographic area of responsibility. It will be imperative for the Specialty Sales Director to work closely with the other Sales Directors and the Vice Presidents… more
- Stanford Health Care (Palo Alto, CA)
- …America) **This is a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's Office, ... Department of Health Care Access and Information (HCAI) In addition, the Director of Reimbursement oversees the organization's responses to government audits and… more
- Integra Partners (Troy, MI)
- The Senior Medical Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is ... require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads medical… more
- Humana (Raleigh, NC)
- **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
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with… more
- Humana (Carson City, NV)
- **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
- Humana (Harrisburg, PA)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Charleston, WV)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board ... Certified Oncologist for this opportunity. This is a remote based from from home role. The Medical...development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will… more
- Humana (Jefferson City, MO)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Honolulu, HI)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- Humana (Lincoln, NE)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- Dignity Health (Bakersfield, CA)
- …offices, primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing ... drive efficiency, and address impactable variation. - Serve as the physician medical director for the Population Health Services Organization (PHSO) quality… more
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