- AdventHealth (Altamonte Springs, FL)
- …drafting and submitting clinical denial appeals , as needed + Develops Medical Director relationships with payors to have open communication and consistently ... as a liaison between UM and CM teams and medical staff, as well as, the medical ...Officers and acts as a liaison between contracted Managed Care/ Commercial payors related to managed care denials, Care Management… more
- Elevance Health (Los Angeles, CA)
- **Behavioral Health Medical Director - Child Psychiatrist** Location: This role enables associates to work virtually full-time, with the exception of required ... Fulltime position, Monday through Friday. Open to part-time. The **Behavioral Health Medical Director - Child Psychiatrist** is responsible for completing … more
- State of Colorado (Denver, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... Division Director - Management Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5014697) Apply Division Director - Management Salary… more
- Bayer (Boston, MA)
- …supporting HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals . Develop ... + In depth understanding of Payer/PBM therapy approval requirements (Prior Authorization, Medical Necessity, Denial Appeals , Formulary coverage and payment for… more
- Banner Health (Phoenix, AZ)
- …Clinical Decision Making **Work Shift:** Day **Job Category:** Physicians The Senior Medical Director , Network Performance is a senior clinical executive ... leadership, enterprise collaboration, and credible clinical engagement, the Senior Medical Director will ensure Banner's network strategy consistently… more
- Takeda Pharmaceuticals (Boston, MA)
- …purpose and be empowered to deliver your best. Join Takeda as the Associate Director , Patient Services Operations out of our Cambridge, MA office. As the Associate ... Director , Patient Services Operations, you will lead the design,...Sales Leadership, Marketing, Contracts and Pricing, Legal, Compliance, Training, Medical and Scientific Affairs and Regulatory, along with relevant… more
- Marathon Petroleum Corporation (Salt Lake City, UT)
- …our people, and fosters a collaborative team environment. Overview: The Supply Chain Director is responsible for all ongoing Supply Chain activities within the Salt ... ensures that the refinery takes full but fair advantage of its commercial position when procuring services, materials, and equipment, managing risk, maintaining… more
- CVS Health (Scottsdale, AZ)
- …And we do it all with heart, each and every day. As the Lead Director of Market Conduct Exams for the Network Services area, you will have the opportunity ... pertaining to PBM network comprehensive activities. In this role the Lead Director will be responsible for developing our internal (Government Affairs) and external… more
- Somatus (Mclean, VA)
- …the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional ... well-being + Community engagement opportunities + And more! The Director of Quality, reporting to the AVP of Quality,...guidance and oversight to all lines of business including Commercial , Medicaid, Medicare, and Special Need Plans (SNPs). The… more
- City and County of San Francisco (San Francisco, CA)
- …service examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service ... is responsible for overseeing a broad range of waterfront commercial , maritime, and public access facilities that are held...item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to… more