- Elevance Health (Nashville, TN)
- ** Medical Director - Medicare ( Part -time)** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... 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 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 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 fundamentals of CMS Medicare Guidance on following ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation...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)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… 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)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... 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
- 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
- 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
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Director Enterprise Emergency Management? 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
- 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** The Resolution team handles all complaints for Humana, including formal grievances, appeals, ... experience for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals), you will be accountable for… 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** Humana is seeking a strategic and experienced Director of Business Performance Management, ... effectiveness, compliance, and the achievement of key business objectives. The Director will be responsible for establishing clear performance metrics, driving… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and ... for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an in-depth understanding...protect member PHI / HIPAA information **Interview Format** As part of our hiring process, we will be using… more