• Director , Payment Integrity…

    BlueCross BlueShield of North Carolina (NC)
    **Job Description** Direct, manage and lead highly complex functional business area within Clinical Coding Review (CCR) to define and enable strategic and ... the organization at external meetings with vendors, providers and customers as the clinical coding review expert and decision maker when needed + Create new … more
    BlueCross BlueShield of North Carolina (06/21/25)
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  • Medical Director - Radiation Oncology

    CVS Health (Phoenix, AZ)
    …you will focus on prior authorization cases and consultation cases. The Medical Director will provide clinical , coding , and reimbursement expertise as ... Special Projects and Committee participation when needed. + The Medical Director will provide clinical , coding , and reimbursement expertise as well as… more
    CVS Health (06/21/25)
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  • Medical Director

    CVS Health (Phoenix, AZ)
    …Appeals / Special Projects and Committee participation when needed. + The Medical Director will provide clinical , coding , and reimbursement expertise as ... in support of medical management programs through participation in clinical team activities. + The Medical Director will act as lead business and clinical more
    CVS Health (06/18/25)
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  • Medical Director - New Jersey Market

    CVS Health (Dover, DE)
    …Level Appeals / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise as ... in support of medical management programs through participation in clinical team activities. The Medical Director will act as lead business and clinical more
    CVS Health (06/18/25)
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  • Medical Director (Great Lakes)

    CVS Health (Springfield, IL)
    …Appeals / Special Projects and Committee participation when needed. + The Medical Director will provide clinical , coding , and reimbursement expertise as ... in support of medical management programs through participation in clinical team activities. + The Medical Director will act as lead business and clinical more
    CVS Health (06/05/25)
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  • Medical Director - Commercial Appeals

    CVS Health (Denver, CO)
    …Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise ... well as directing case management when necessary. The Medical Director will act as a business and clinical... Director will act as a business and clinical liaison to network providers and facilities if needed,… more
    CVS Health (06/18/25)
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  • Manager - Hospital Coding

    Columbus Regional Hospital (Columbus, IN)
    …of Information. Reporting to the Director - System Health Information, Coding & Clinical Documentation, this position is responsible for managing, directing, ... you need to know about this position: + The Hospital Coding & Clinical Documentation department focuses on complete, accurate and compliant documentation and… more
    Columbus Regional Hospital (06/04/25)
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  • Manager, Itemized Bill Review

    Zelis (NJ)
    …The Manager, Itemized Bill Review will collaborate closely with the Sr. Manager and Sr. Director of Clinical Coding serving as the Subject Matter Expert on ... will research and stay abreast of inpatient and outpatient coding updates to ensure the team is capturing all...saving opportunities. The Manager, IBR will investigate areas of coding opportunities within the current product and be responsible… more
    Zelis (04/08/25)
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  • Director - Hospital Coding (Remote)

    Stanford Health Care (Palo Alto, CA)
    …of America) **This is a Stanford Health Care job.** **A Brief Overview** The Director - Hospital Coding oversees, directs, and provides leadership of the ... facility coding function across the enterprise, acting within the Mid...quality reviews and other billing edit work queues. The Director participates in the formulation of objectives and strategies… more
    Stanford Health Care (06/12/25)
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  • Medical Director (Medical Policy…

    CVS Health (Hartford, CT)
    …opportunities to improve the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure alignment and correct ... quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director ...and business direction in these areas. Knowledge of Aetna clinical and coding policy and experience with… more
    CVS Health (06/23/25)
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