- CVS Health (Frankfort, KY)
- …it all with heart, each and every day. **A Brief Overview** The Lead Director , Provider Data Compliance is responsible for overseeing the compliance of provider data ... initiatives to support audit readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout this ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, California,...the Southeast Region (FL, LA and WV). This Medical Director will be a "Work from Home" position primarily… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis analyzes and forecasts financial, economic, and other data ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Prime Therapeutics (Frankfort, KY)
- …including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid . The Sr Director , Pharm Trade Relations leads a team of ... Sr Dir Pharmacy Trade Relations - Remote **Job Description** The Sr Director , Pharmaceutical Trade Relations is responsible for managing Prime's Trade Relations… more
- Humana (Frankfort, KY)
- …Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical ... policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Humana (Frankfort, KY)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of… more
- Humana (Frankfort, KY)
- …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 ... must be able to start with 30-60 days of hire. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether… more
- Humana (Frankfort, KY)
- …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 provides medical interpretation and decisions about the appropriateness of services… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). ... The Medical director work assignments involve moderately complex to complex issues...medical management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Experience with national… more
- Molina Healthcare (KY)
- …improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... Medicaid , NCQA and other regulatory requirements. + Reviews quality...including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge.… more
Recent Jobs
-
Assembler II, 1st Shift - BHE
- Alfa Laval (Richmond, VA)
-
Senior Product Designer, Ads & Promos
- DoorDash (San Francisco, CA)
-
Submarine Engineering Technician (Skillbridge Intern)
- Huntington Ingalls Industries (Newport News, VA)
-
Patient Account Rep I Corporate
- Covenant Health Inc. (Knoxville, TN)