- Elevance Health (Nashville, TN)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...specific position is $125,118 to $214,488. Prorated based on part -time hours. Locations: Illinois, Washington DC, New York In… more
- Humana (Nashville, TN)
- **Become 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 (Nashville, TN)
- **Become 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
- Humana (Nashville, TN)
- **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 (Nashville, TN)
- **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 (Nashville, TN)
- **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
- Evolent (Nashville, TN)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Nashville, TN)
- …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 (Nashville, TN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... 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
- BAYADA Home Health Care (Franklin, TN)
- …company in a fast-growing industry? Would you like that growth and success to be part of making a real difference in people's lives? We're BAYADA Home Health Care-a ... care manager to fill the position of Home Health Director in our **Franklin, Tennessee** territory. **As a Home...employees, referral sources, and community resources while growing this Medicare Certified Home Health Office. + Responsible for the… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us...high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality ... rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Director Regulatory and Accreditation WFH? At HCA Healthcare, you come first. HCA Healthcare has ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Evolent (Nashville, TN)
- …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
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Associate Director , Business Systems Analysis performs analysis of business, process ... analysis and translation into proper system requirement specifications. The Associate Director , Business Systems Analysis requires a solid understanding of how… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** At Humana, we are on a mission to provide an exceptional engineering experience for our ... and overall experience with our products. As the Associate Director of DevOps Platforms in the Enterprise Engineering Enablement...positive team culture that people want to be a part of. + You are detail oriented and have… more
- HCA Healthcare (Nashville, TN)
- …an organization that invests in you as a Regulatory and Accreditation Clinical Compliance Director ? At HCA, you come first. HCA Healthcare has committed up to $300 ... offer eligible colleagues an attractive benefit package that includes medical , wellbeing, dental and vision benefits along with some...Clinical Compliance Audit Manager? like you to be a part of our team. Job Summary and Qualifications The… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Director , Product Management Leads all phases of the product life cycle, from ... as a 5 member team of Agile coaches. The Director , IT Product Management works with relevant Humana stakeholders...and Associate Directors in developing a Product Mindset as part of the Product Operating Model *Establishes processes, standards,… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and ... diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data… more
- Prime Therapeutics (Nashville, TN)
- …and drives every decision we make. **Job Posting Title** Trade Client Relations Director - Remote **Job Description** The Trade Client Relations Director is ... responsible for the analysis, modeling and delivery of innovative pharmacy and medical rebate strategies and cost saving solutions to Prime's clients to ensure Prime… more
- Evolent (Nashville, TN)
- …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to solve ... impact on the organization and patient health. This role supports both medical cost management activities and business development efforts. **What You Will Be… more