• Medical Policy Director

    Commonwealth Care Alliance (Boston, MA)
    …CCA-Central Clin Ops Leadership **Position Summary:** Reporting to the Sr. Medical Director of Utilization Management (UM) and Policy, the Medical Policy Director ... to the population serviced by CCA. The Medical Policy Director is an independent contributor who works in partnership...with internal business areas such as payment policies and claims to ensure alignment between other CCA areas and… more
    Commonwealth Care Alliance (08/31/25)
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  • Medical Director Physician Advisor UM

    AdventHealth (Altamonte Springs, FL)
    …Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient ... denial management by reviewing and making recommendations on appealed provider claims and makes determinations for appeals and grievances from patients; assists… more
    AdventHealth (08/07/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health Plan's (SHP) ... practice of medicine. + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons License - Medical Board of CA -REQUIRED… more
    Sharp HealthCare (07/19/25)
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  • Senior Director , Quantitative Science…

    dsm-firmenich (Princeton, NJ)
    **Senior Director ** **Quantitative Science** **Location:** Princeton, NJ or Lexington, MA Looking for a new challenge? Yearning to be part of an organization that ... brings progress to life? Read on! We're #hiring for **Senior Director ** **Quantitative Science** . This global leadership role leads a multidisciplinary team and… more
    dsm-firmenich (08/26/25)
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  • Director & Sr. Counsel II - Pharmaceutical…

    Boehringer Ingelheim (Ridgefield, CT)
    …business teams providing reimbursement, education and other support to patients. The Director & Sr. Counsel provides a broad range of legal services, typically ... company's businesses. Mentors more junior attorneys in areas of expertise. In this role as Director / Senior Counsel you will be a part of the team to support our… more
    Boehringer Ingelheim (07/26/25)
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  • Assistant Director of Grants, Bureau…

    City of New York (New York, NY)
    …effectively and meet DOHMH's strategic objectives Position Summary: The assistant director is responsible for monitoring and tracking all Federal, State, Private, ... and intra-city award budgets, expenses, invoice/drawdown submissions, claim verifications, booking/realizing receivables, and annual/final Federal Financial Reports… more
    City of New York (08/13/25)
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  • Sr. Product Manager - Claims Management

    Waystar (Louisville, KY)
    **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Sr. Product Manager ... will coordinate with key stakeholders in sales, marketing, design, development, and operations. This role will be charged with leading game changing efforts at Waystar within the company's Product team for new to market and existing solutions. **WHAT YOU'LL… more
    Waystar (08/08/25)
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  • Director , Strategic Accounts (Remote)

    Seek Now (KY)
    …to deliver high-quality, reliable inspection services that speed up carriers' claim cycles while providing exemplary customer service. The company's unique ... technology platform accelerates the industry's shift to virtualizing the claim adjustment model, working with more than 300 Property & Casualty (P&C) Insurance… more
    Seek Now (08/07/25)
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  • Assistant Director of Laboratories, DOH

    Commonwealth of Pennsylvania (PA)
    Assistant Director of Laboratories, DOH Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5032912) Apply  Assistant Director of Laboratories, ... Department of Health (DOH) is seeking a driven Assistant Director of Laboratories to join our dedicated team. T...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
    Commonwealth of Pennsylvania (08/26/25)
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  • Medical Director - Medical Policy…

    CVS Health (Hartford, CT)
    …Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the ... Health company has an outstanding opportunity for a Medical Director . Ready to take your career to the next...Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but… more
    CVS Health (08/28/25)
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