- Humana (Helena, MT)
- …our caring 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...Medicare Advantage and managed Medicaid + Experience with national guidelines such as MCG(R), ASAM or InterQual +… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- CVS Health (Sacramento, CA)
- …of covered benefits in the Commercial and Medicare environment with a focus Medicare policy., This Medical Director provides subject matter expertise in ... CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career...Policy, Reimbursement and Health Care Systems. * Experience with Medicare policies and guidelines ( National Coverage Determination… more
- Humana (Honolulu, HI)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- CVS Health (Hartford, CT)
- …compassionate. And we do it all with heart, each and every day. Executive Director , Medicare Part D Strategy leader will lead the development and advancement ... of the organization's strategy for Medicare Part D, spanning both the Part D portion...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CVS Health (Hartford, CT)
- …all with heart, each and every day. **Position Summary** The Divisional CFO for Medicare Part D and Medicare Supplement is responsible for the financial ... + Serve as the chief financial partner to the Medicare Part D and Medicare Supplement business...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CVS Health (Blue Bell, PA)
- …in this role will serve as the subject matter expert for Aetna's Medicare Advantage Special Needs Plans (SNP) business. Includes Dual Eligible, HIDE/FIDE Integrated, ... and Chronic plans. The SNP population presents a huge growth opportunity for Medicare Advantage plans, and Aetna is aggressively expanding into this market. This… more
- Elevance Health (AR)
- Provider Network Management Director ( Medicare Network Build) JR167138 **Preferred Location** : Commuting distance to the Little Rock, Arkansas office. **Hybrid ... is granted as required by law._ The **Provider Network Management Director ** develops the provider network in **Arkansas** through contract negotiations,… more
- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... with regulatory, state, corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician committees including… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… more