- Elevance Health (Metairie, LA)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- CVS Health (Hartford, CT)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary ... encumbrances * Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience.… more
- Humana (Columbus, OH)
- …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
- Molina Healthcare (Columbus, OH)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Columbus, OH)
- …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
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. + **Position Purpose:** Assist the Medicare Chief Medical Officer to develop and implement our enterprise ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve… more
- ChenMed (Richmond, VA)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
- RVO Health (Charlotte, NC)
- **AT A GLANCE** RVO Health is looking for an Associate Director , Medicare Product Manager to improve how seniors find and select their Medicare plans. 88% of ... seniors report that they find enrolling in a Medicare plan to be confusing and overwhelming. Our mission...different subjects at your fingertips + Health Insurance Coverage ( medical , dental, and vision) + Life Insurance + Short… more
- CVS Health (Springfield, IL)
- …process, pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject ... 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 Fortune… more
- University of Miami (Miami, FL)
- …when necessary + Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population ... evaluations. This role also works directly with staff, administration, medical directors, and other relevant stakeholders to assure appropriate...preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of… more
- Centene Corporation (Queens, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is...position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Scientist supports analytic activities associated with BCBSMA overall performance on Medicare Stars ratings, with specific focus on CAHPS patient experience ... to help identify the most efficient means through which Medicare Stars clinical quality and patient experience performances at...into a cohesive view. Under direction of the Senior Director of Population Health Analytics, the Data Scientist will… more
- Centene Corporation (Providence, RI)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... Payment Initiatives (VBP) will support the expansion and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage… more
- Humana (Columbus, OH)
- **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
- Humana (Columbus, OH)
- **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
- Centene Corporation (Dover, DE)
- …and Supports (LTSS) and Medicare -Medicaid Duals populations. Additionally, the Medical Director will collaborate with other key stakeholders to provide ... with the LTSS Director and Care Coordination Director to manage and optimize LTSS and Medicare...LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO)… more
- Humana (Columbus, OH)
- **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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This is a remote based, work ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Abbott (Washington, DC)
- …spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues ... serve people in more than 160 countries. **Job Title** Director , Corporate Reimbursement, Government Affairs **The Opportunity** This position works out of our… more
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