- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …Must demonstrate a high level of understanding of regulations related to promotion compliance . May be assigned additional responsibilities as deemed necessary. ... Must demonstrate a high level of understanding of regulations related to promotion compliance . May be assigned additional responsibilities as deemed necessary.… more
- Vanderbilt University Medical Center (Nashville, TN)
- …care, education, and research. **Organization:** Quality Admin **Job Summary:** The Associate Director supervises, coordinates and monitors the work activity ... . The VUMC Quality Administration Laboratory Department is in need of a ** Associate Director ** to join the team! **Department Summary:** Our new… more
- Humana (Nashville, TN)
- …a part of our caring community and help us put health first** The Associate Director , Business Systems Analysis performs analysis of business, process and user ... cost/benefit analysis and translation into proper system requirement specifications. The Associate Director , Business Systems Analysis requires a solid… more
- Humana (Nashville, TN)
- …Description Humana's Insurance IT organization is seeking an experienced and strategic Associate Director , Technology Solutions to lead technology efforts within ... processes, and enterprise data management is highly preferred. The Associate Director , Technology Solutions acts as a...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- The Associate Director , Channel Analytics will be a key member of the Business Analysis team, responsible for leading marketing mix and channel analytics to ... of promotional investments across various channels (HCP, DTC, digital, non-personal promotion , etc.). + Develop and refine multi-touch attribution models and other… more
- CenterWell (Nashville, TN)
- …training program for coding staff to ensure continuous skill development and compliance with coding standards. + Partner with analytics and audit to identify ... coder errors and develop plans to address deficiencies/specific areas of focus. ** Associate Engagement and Retention:** + Develop and implement strategies to foster… more
- Humana (Nashville, TN)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Nashville, TN)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Nashville, TN)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other… more
- Humana (Nashville, TN)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Nashville, TN)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical… more
- Humana (Nashville, TN)
- …community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid builds strategies for development, ... clinical practices and processes for clinical community within the enterprise. The Director , Clinical Strategy and Practice requires an in-depth understanding of how… more
- Humana (Nashville, TN)
- …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 scope and complexity...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Humana (Nashville, TN)
- …experience for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals), you will be accountable for ... and/or other end compliant inquiries. + Has 6-7 direct reports including Associate Directors, Managers, and Senior Professionals + Provides strategic direction and… more
- Humana (Nashville, TN)
- …of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and strategic planning ... support for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an in-depth understanding of how organization… more
- CenterWell (Nashville, TN)
- …a part of our caring community and help us put health first** The Director , Account Management is responsible for growing membership within existing accounts and for ... directly managing business relationships with client accounts. The Director , Account Management requires an in-depth understanding of how organization capabilities… more
- CenterWell (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Director Drug Trend and Pipeline Forecasting will be the leader of Forecasting and would ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Community Health Systems (Antioch, TN)
- **Job Summary** The Payment Compliance & Contract Management (PCCM) Collector (REMOTE) is responsible for the timely and efficient resolution of underpaid and ... Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements. **Essential Functions** + Manages account follow-up… more
- CenterWell (Nashville, TN)
- …professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their ... and lead with the care team through daily huddles. . Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of cooperation in… more
- Humana (Nashville, TN)
- …2 collects and reviews records, summarizes issues, works with Medical Director as needed, and implements corrective actions as assigned. Coordinates case ... to Patient Safety Peer Review Committee. Audits quality cases for compliance and participates in department projects as available. Understands department, segment,… more