- Humana (Juneau, AK)
- **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 (Juneau, AK)
- …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 (Juneau, AK)
- **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 (Juneau, AK)
- …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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Evolent (Juneau, AK)
- …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
- Humana (Juneau, AK)
- …part of our caring community and help us put health first** The Director of Regulatory Compliance develops and implements compliance programs aimed at governmental ... requirements and regulations across Humana Specialty and Military products. The Director manages dedicated compliance teams of associates who oversee compliance… more
- Evolent (Juneau, AK)
- …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. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Juneau, AK)
- …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 (Juneau, AK)
- …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 ... recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Evolent (Juneau, AK)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Evolent (Juneau, AK)
- …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 (Juneau, AK)
- …of our caring community and help us put health first** The Director , Provider Engagement develops and grows positive, long-term relationships with physicians, ... within the contracted working relationship with the health plan. The Director , Provider Engagement requires an in-depth understanding of how organization… more
- Humana (Juneau, AK)
- …Insurance IT organization is seeking an experienced and strategic Associate Director , Technology Solutions to lead technology efforts within the Enrollment domain. ... financial processes, and enterprise data management is highly preferred. The Associate Director , Technology Solutions acts as a liaison and collaborates with the… more
- CenterWell (Juneau, AK)
- …Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner ... of management experience + 8 or more years of Medical Coding, IPA, or similar experience + Medical...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- CenterWell (Juneau, AK)
- …an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health, Accountable Care Organizations (ACOs), medical ... with healthcare industry including value-based care, health plans, health systems, Medicare , accountable care, population health, medical group management /… more
- Datavant (Juneau, AK)
- …and external stakeholders. The manager will collaborate with other managers and the department director to set strategy and mobilize the team to be as performant as ... their direct reports with guidance and collaboration from the director and other department managers + Develop core relationships...(2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+… more