- Humana (Montpelier, VT)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis analyzes and forecasts financial, economic, and other data ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Humana (Lansing, MI)
- …first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes ... diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors… more
- CVS Health (Oklahoma City, OK)
- …is a remote -based (work from home) role.** In this role as Medical Director (Behavioral Health), you will: * Provide leadership and day-to-day physician ... utilization management team, including the management of high-risk cases and medical necessity decisions * Provide comprehensive behavioral health care management to… more
- RWJBarnabas Health (Oceanport, NJ)
- Director , Corporate Reimbursement (Hybrid/ Remote ) - Oceanport, NJReq #:0000180233 Category:Professional / Management Status:Full-Time Shift:Day ... $209,501.00 per year Location: Oceanport, Oceanport, NJ 07052 Job Title: Director Location: Barnabas Health Corp Department: Corporate Reimbursement Req#: 0000180233… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other...7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Centene Corporation (Salem, OR)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Evolent (Dover, DE)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Concord, NH)
- …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...Medical Directors will learn Medicare, Medicare Advantage and Medicaid requirements, and will understand how to operationalize this… more
- Molina Healthcare (Des Moines, IA)
- …standards and requirements established by the Centers for Medicare and Medicaid . **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the ... 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims, Surgery, Anesthesia, high dollar… more
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