• Medical Director-Payment Integrity

    Humana (Carson City, NV)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (12/11/25)
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  • Medical Coding Educator

    Humana (Fort Lauderdale, FL)
    …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... us put health first** The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned … more
    Humana (12/09/25)
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  • Director, Network Contracting

    Point32Health (Canton, MA)
    …long-term, mutually successful relationships with strategic providers. + Engage with the provider performance team to understand and monitor provider ... and experience working collaboratively with providers. + Preferred: 10-15 years of Medicare Advantage experience. Skill Requirements + Energetic, goal driven… more
    Point32Health (01/01/26)
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  • Medical Director - Pharmacy Appeals

    Humana (Lincoln, NE)
    …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will ... Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in...experience in a medical management review organization such as Medicare Advantage , managed Medicaid, or Commercial health… more
    Humana (12/03/25)
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  • Growth Strategy Principal - IPA Development

    CenterWell (Frankfort, KY)
    …approval processes, financial reporting and maintaining market level sales materials for Medicare Advantage and ACO offerings + Develop and implement ... nationally + Negotiate complex IPA/MSO agreements with net new provider groups as well as payor expansions with existing...year experience in Healthcare, with a specific focus on Medicare advantage with a history of effectively… more
    CenterWell (12/04/25)
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  • BI Analyst

    Humana (Little Rock, AR)
    …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... business problems and issues using data from internal and external sources to provide insight to decision-makers BI Analyst / Business Intelligence Engineer 2 +… more
    Humana (12/19/25)
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  • Medical Specialist 1

    New York State Civil Service (Binghamton, NY)
    …be terminated from your employment.If appointed, you may be required to become an enrolled Medicare provider ; obtain and provide to your employer a National ... approve leave and track time and attendance; and complete performance evaluations. * Functions as a member of an...Comprehensive Adult Transitional Home if required, when the assigned provider is not available.* Provide medical expertise… more
    New York State Civil Service (12/19/25)
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  • Medical Director - Medicaid (remote)

    Humana (Washington, DC)
    …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (01/01/26)
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  • Medical Director - IP Claims Management

    Humana (Raleigh, NC)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage , and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (12/11/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Jefferson City, MO)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (11/15/25)
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