- Centene Corporation (Raleigh, NC)
- …of performance improvement initiatives for network providers. + May assist Chief Medical Director in planning and establishing goals and policies to ... committees including committee structure, processes, and membership. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and … more
- CVS Health (Tallahassee, FL)
- …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and objectives for… more
- Humana (Indianapolis, IN)
- …and build collaborative care models in their practices + Coordinates with the Medical Director to integrate the administration and management of behavioral and ... in this role collaborates closely with Clinical Services and the Chief Medical Officer(CMO) to integrate the day-to-day administration and strategic management of… more
- Ascendis Pharma (Princeton, NJ)
- …mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly ... develop their skills. Ascendis Pharma is looking to hire an experienced Director , Market Access Contract Operations to join our team. Responsibilities will include… more
- Molina Healthcare (Fort Worth, TX)
- …under-utilization. * Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews… more
- BrightSpring Health Services (Gainesville, FL)
- Our Company ResCare Community Living Overview The Assistant Director of Nursing is responsible for assisting the Director of Nursing with the daily performance ... performance of the unit. Responsibilities + Coordinates with and assists the Director of Nursing with planning, coordinating, delivering, and overseeing the delivery… more
- CVS Health (Hartford, CT)
- …each and every day. **Position Summary** CVS Health is recruiting for a Lead Director , AI & Data Strategy Principal. The Medicare Technology organization at CVS ... programs solving complex problems to improve and modernize our data strategy for Medicare , working across the enterprise to align with data governance and AI… more
- Sunrise Senior Living (Charlottesville, VA)
- …of.** **COMMUNITY NAME** The Colonnades **Job ID** 2025-234942 **JOB OVERVIEW** The Director of Nursing is responsible for providing leadership and management to the ... and implements plans of correction for concerns and issues identified by pharmacy consultants. + Reviews and develops plans of correction with interdisciplinary team… more
- Grifols Shared Services North America, Inc (Research Triangle Park, NC)
- …and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing ... access customer segment . Support reimbursement, coding, and coverage-related responsibilities for Medicare Part B, Centers for Medicare and Medicaid (CMS)… more
- The Cigna Group (Bloomfield, CT)
- ** Medical Principal Job Description** **Position scope:** Primarily regional with national level case work for Cigna Healthcare (CHC) -- Cigna. **Summary description ... of position** : A Medical Principal performs medical review and case...and consultant to utilization management, case management, network, contracting, pharmacy , and service operations (claims). This is an entry… more