- CVS Health (Phoenix, AZ)
- …and more compassionate. And we do it all with heart, each and every day. **Position Summary** The Lead Director , Pharmacy Appeals will lead a team of ... as well as guiding other internal business units to resolve issues quickly. The Lead Director , Pharmacy Appeals is also responsible for working with the… more
- Molina Healthcare (Chandler, AZ)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead , the medical director , and quality improvement staff. + ... providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management. + Develops and implements… more
- Humana (Phoenix, AZ)
- …to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy ), and reviews for DME, genetic testing, ... adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical Director … more
- Molina Healthcare (Chandler, AZ)
- …and review BH portions of state contracts * Assist the BH MD lead trainers in the development of enterprise-wide teaching on psychiatric diagnoses and treatment ... second level BH clinical reviews, BH peer reviews and appeals * Supports BH committees for quality compliance. *...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- Sanofi Group (Phoenix, AZ)
- …**About the Job** Field Reimbursement Manager, Rheumatology reports to the Director , Field Reimbursement Managers for the Rheumatology Business Unit The Field ... Rheumatology Patient Support Services and communicate and collaborate cross-functionally to lead Kevzara pull through efforts while assisting sales partners as… more