• Medical Director - Medicare Appeals

    CVS Health (Nashville, TN)
    …Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise as ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...directing case management when necessary. The Medical Director will act as a business and clinical more
    CVS Health (08/08/25)
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  • Manager, Risk Adjustment Coding Support

    Evolent (Nashville, TN)
    …The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be ... coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and...healthcare administration, or a related field. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder)… more
    Evolent (08/14/25)
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  • Regional Coding Operations Manager WFH

    HCA Healthcare (Nashville, TN)
    coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... and workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division… more
    HCA Healthcare (06/21/25)
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  • Coding Spec-Clinic

    Covenant Health Inc. (Knoxville, TN)
    …directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as ... coding . + Educates and assists physicians and clarifies coding versus clinical issues. + Works closely...Attends meetings and provides input as it relates to coding , medical documentation, and reimbursement issues specific… more
    Covenant Health Inc. (08/04/25)
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  • Regional Coding Operations Manager WFH

    HCA Healthcare (Nashville, TN)
    coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... and workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division… more
    HCA Healthcare (06/21/25)
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  • Clinical Documentation and Claims Integrity…

    Elevance Health (Nashville, TN)
    ** Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... of life through home-care and community based services. The ** Clinical Document Improvement Director ** is responsible for...of related experience, including 3 years of hands-on HCC coding , chart review, and RAF calculations; or any combination… more
    Elevance Health (08/14/25)
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  • Medical Director - Florida

    Humana (Nashville, TN)
    **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...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and… more
    Humana (07/29/25)
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  • Associate Medical Director

    Sumitomo Pharma (Nashville, TN)
    …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... Serious Adverse Event Reports (SAEs), and Product Complaints (PCs) + Contributes to medical safety of clinical trials, including monitoring of clinical more
    Sumitomo Pharma (08/15/25)
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  • Director , Prospective + Concurrent Risk…

    Datavant (Nashville, TN)
    …to deliver complex healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, ... requirements, medical record standards, and regulatory guidance impacting concurrent coding or risk adjustment. + Product experience integrating into EHRs or… more
    Datavant (08/08/25)
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  • Director of Physician Resource Group

    HCA Healthcare (Brentwood, TN)
    …for the business and clinical functions through administrative and clinical staff including providers, front desk, medical records, nursing, and ... **Introduction** Do you have the career opportunities as a ** Director of Physician Resource Group** you want with your...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
    HCA Healthcare (06/21/25)
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