- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- CVS Health (Hartford, CT)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary ... encumbrances * Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience.… more
- Humana (Topeka, KS)
- …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 (Sacramento, CA)
- …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
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. + **Position Purpose:** Assist the Medicare Chief Medical Officer to develop and implement our enterprise ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Centene Corporation (Queens, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is...position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as… more
- RWJBarnabas Health (Oceanport, NJ)
- Director , Corporate Reimbursement (Hybrid/ Remote ) - Oceanport, NJReq #:0000180233 Category:Professional / Management Status:Full-Time Shift:Day ... partnership with the Vice President of Corporate Reimbursement, the Director will manage the completion of DSH, Medicare...and financial health. + Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Dental and Vision… more
- Evolent (St. Paul, MN)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Centene Corporation (Providence, RI)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... Payment Initiatives (VBP) will support the expansion and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The VP Medical Director of Clinical Programs will manage the Health Plan Medical ... Contributes to and advises in product design and the Medicare bid processes + Contributes to and advises in...areas of MHPC, as needed + Assists the Market Medical Director for building and deepening relationships… more
- Danaher Corporation (Atlanta, GA)
- …the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for ... coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will play a pivotal… more
- Prime Therapeutics (Springfield, IL)
- …and drives every decision we make. **Job Posting Title** Trade Client Relations Director - Remote **Job Description** The Trade Client Relations Director ... is responsible for the analysis, modeling and delivery of innovative pharmacy and medical rebate strategies and cost saving solutions to Prime's clients to ensure… more
- Molina Healthcare (Santa Fe, NM)
- **JOB DESCRIPTION** **Job Summary** This role provides the option for remote work, ideally suited for candidates living in the Eastern Time Zone. Regional ... Director Quality Solutions (QS) is responsible for contributing to...as the subject matter expert for all, Medicaid / Medicare / Marketplace quality, and data acquisition functions to… more
- Walgreens (Deerfield, IL)
- …Employer, including disability/veterans". \#LI-TO1 **Job ID:** 1414700BR **Title:** National Director , Consultant Relations - Remote **Company Indicator:** ... Systems, various other providers, etc), the various lines of business (Commerical, Medicare , Medicaid, etc) and the various healthcare services provided in the… more
- Humana (Salem, OR)
- **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
- Centene Corporation (Dover, DE)
- …and Supports (LTSS) and Medicare -Medicaid Duals populations. Additionally, the Medical Director will collaborate with other key stakeholders to provide ... with the LTSS Director and Care Coordination Director to manage and optimize LTSS and Medicare...LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO)… more
- Humana (Annapolis, MD)
- **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
- CVS Health (Springfield, IL)
- …Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This is a remote based, work from home opportunity. The ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …overseeing all activities related to the third-party administration of self-funded medical , dental, and specialty benefits. Additionally, the Director ... with additional in-office presence as needed._** Founded in 1934, Medical Mutual is the oldest and one of the...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s status as a ... Founded in 1934, Medical Mutual is the oldest and one of...keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more