- Humana (Washington, DC)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Sedgwick (Alexandria, VA)
- …a plus, not required. **Experience:** Ten (10) years of relationship building in the claims management or risk management area or equivalent combination of ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (Northeast Region) As a Business Development… more
- Immigration and Customs Enforcement (Washington, DC)
- …two years of experience related to program management , administration, Healthcare management , finance or medical claims is preferred. Qualifying degree ... eOPF. Well-developed knowledge and skills in the areas of claims management and medical necessity....Director for Healthcare Compliance, Office of Health Plan Management Unit (HPMU). The incumbent reports directly to the… more
- CenterWell (Washington, DC)
- …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
- Humana (Washington, DC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Washington, DC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Merck (Washington, DC)
- **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
- Humana (Washington, DC)
- …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Georgetown Univerisity (Washington, DC)
- …, warranty issues, and arbitration issues; and oversight on other project management -related duties and activities. The Director must have intimate knowledge ... solutions for potential problems discovered in the design and construction process. The Director helps ensures all aspects of project management are effectively… more
- Sumitomo Pharma (Washington, DC)
- …a dynamic, highly motivated, and experienced individual for the position of **Associate Director , Commercial Data Management ** . This high impact role requires a ... technically skilled person to support our growing Commercial Data Management (CDM) function, serving as a key liaison between...(Salesforce, Veeva), syndicated data (IQVIA & Symphony sales and claims data, MMIT) The base salary range for this… more
- Marriott (Washington, DC)
- …plans to monitor and control risk. * Reports any procedure violations to the Director of Loss Prevention and appropriate management . * Strives to improve service ... $96,000 annually **Bonus Eligible:** Y **JOB SUMMARY** Assists the Director of Loss Prevention in managing the daily functions...OSHA programs and statistical data. * Assists in the management of claims by ensuring proper procedures… more
- Otsuka America Pharmaceutical Inc. (Washington, DC)
- **Job Summary** **Job Description** The Associate Director (AD), Federal Government Affairs, will assist in the development, communication, and deployment of ... Health, Nephrology, Immunology, and Rare Disease. This role reports directly to the Director , Federal Government Affairs and located in the Washington, DC area. The… more
- Otsuka America Pharmaceutical Inc. (Washington, DC)
- **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
- Sedgwick (Washington, DC)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... care. Preferred experience in: client services, clinical operations, and or workers comp claims ** . To determine account management strategies related to client… more
- Otsuka America Pharmaceutical Inc. (Washington, DC)
- **Position Summary:** The Director GVE Operations oversee and coordinates projects within the department to ensure alignment with organizational goals. This role is ... other integrated data generation initiatives. This position reports to the Senior Director , Global Integrated Evidence & Innovation Operations and can be based in… more
- Otsuka America Pharmaceutical Inc. (Washington, DC)
- …HCPs. The Director will work cross-functionally with sales, market access, medical affairs, and commercial operations to align on strategic priorities and ensure ... **Position Summary** The Director , HCP Marketing Lead guides the healthcare provider...engagement. + **KOL Engagement & Speaker Programs:** Partner with medical and sales teams toidentifyand engage key opinion leaders… more
- Otsuka America Pharmaceutical Inc. (Washington, DC)
- **Associate Director , Field Strategy, Nephrology/Immunology** **Position overview:** The **Associate Director , Field Strategy** plays a critical role in enabling ... execution and provide feedback to optimize performance at all levels + **Compliance Management :** + Must comply with all state and federal laws, regulations and… more
- AmeriHealth Caritas (Washington, DC)
- …and associated service level agreements for all Operational Areas including: Claims , Configuration Information Management , Enrollment, Contact Center Operations, ... **Job Responsibilities** The Director Operations (Healthy DC Plan) reports to the...issues/risks to ensure established service levels are met (eg, claims accuracy, grievance & appeal timeliness. + Proactively develops,… more
- Otsuka America Pharmaceutical Inc. (Washington, DC)
- **Position Overview:** The Senior Director , MSAT Biologics provides strategic and technical leadership for all late-stage and commercial manufacturing processes for ... through effective technology transfer, validation, process monitoring, and lifecycle management . This individual will serve as the primary technical steward… more
- Wolters Kluwer (Washington, DC)
- . ** Director , IT Business Relationship Management ** **Position Summary** The Director of IT Business Relationship Management (BRM) is a strategic leader ... teams to implement AI-driven solutions that streamline processes such as claims processing and automate repetitive tasks, thereby improving efficiency and accuracy.… more