- Humana (Nashville, TN)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Sedgwick (Nashville, TN)
- …+ Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Director - Claims (REMOTE) Are you looking...preferred. Licenses as required. **Experience** : Ten (10) years claims management experience including three (3) years… more
- HCA Healthcare (Nashville, TN)
- …within HCA Healthcare's Risk & Insurance department reporting directly to the Managing Director of Property Claims . You will support the Insurance programs ... and vendor selection process. + Assist the VP Insurance, AVP Insurance and Manager/ Director of Property Claims with other responsibilities as needed. **What… more
- HCA Healthcare (Nashville, TN)
- …the department and company strategy and philosophy of proactive, efficient and effective claims management . + Manage local claims workflow/processes from the ... the larger Risk & Insurance Department reporting to a Director of Claims . As the Division ...JD) is preferred + 5+ years of experience in claims management , hospital operations, or risk … more
- CenterWell (Nashville, TN)
- …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
- Humana (Nashville, TN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Nashville, TN)
- …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
- Molina Healthcare (Bowling Green, KY)
- …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
- Humana (Nashville, TN)
- …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
- Sumitomo Pharma (Nashville, TN)
- …a dynamic, highly motivated, and experienced individual for the position of **Associate Director , Commercial Data Management ** . This high impact role requires a ... technically skilled person to support our growing Commercial Data Management (CDM) function, serving as a key liaison between...(Salesforce, Veeva), syndicated data (IQVIA & Symphony sales and claims data, MMIT) The base salary range for this… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …our focus to ultra-rare neurological conditions. **Job Summary** The Executive Director , Sales and Marketing, Neurology Rare Disease will be responsible for ... or exceeding Net Sales, Operating Income, and engagement targets. The Executive Director , Sales and Marketing, Neurology Rare Disease will also ensure successful… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- **Job Summary** **Job Description** The Associate Director (AD), Federal Government Affairs, will assist in the development, communication, and deployment of ... Health, Nephrology, Immunology, and Rare Disease. This role reports directly to the Director , Federal Government Affairs and located in the Washington, DC area. The… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- **_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
- BrightSpring Health Services (Nashville, TN)
- …Management and/or Collections in a large healthcare provider setting or a Medical Claims Processing organization. + Proven experience in successfully leading ... Our Company BrightSpring Health Services Overview The Sr. Director is responsible for management of the Revenue Cycle organization and process to ensure the… more
- Molina Healthcare (Bowling Green, KY)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- **Position Summary:** The Director GVE Operations oversee and coordinates projects within the department to ensure alignment with organizational goals. This role is ... other integrated data generation initiatives. This position reports to the Senior Director , Global Integrated Evidence & Innovation Operations and can be based in… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …HCPs. The Director will work cross-functionally with sales, market access, medical affairs, and commercial operations to align on strategic priorities and ensure ... **Position Summary** The Director , HCP Marketing Lead guides the healthcare provider...engagement. + **KOL Engagement & Speaker Programs:** Partner with medical and sales teams toidentifyand engage key opinion leaders… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- **Associate Director , Field Strategy, Nephrology/Immunology** **Position overview:** The **Associate Director , Field Strategy** plays a critical role in enabling ... execution and provide feedback to optimize performance at all levels + **Compliance Management :** + Must comply with all state and federal laws, regulations and… more
- Sedgwick (Nashville, TN)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Client Services Director **PRIMARY PURPOSE** : To determine account management strategies… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- **Position Overview:** The Senior Director , MSAT Biologics provides strategic and technical leadership for all late-stage and commercial manufacturing processes for ... through effective technology transfer, validation, process monitoring, and lifecycle management . This individual will serve as the primary technical steward… more