• Medical Director - National

    Humana (Frankfort, KY)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (07/21/25)
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  • Behavioral Health Medical Director

    Humana (Frankfort, KY)
    …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 (08/09/25)
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  • Medical Director - Medicare

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
    Humana (08/08/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
    Humana (06/18/25)
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  • Senior Medical Director

    Molina Healthcare (KY)
    …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
    Molina Healthcare (06/13/25)
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  • Lead Director , Medicare Actuarial…

    CVS Health (Frankfort, KY)
    …We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal ... candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a strong… more
    CVS Health (07/01/25)
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  • Medical Director - Medicare

    CVS Health (Frankfort, KY)
    …Medicine or Internal Medicine / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
    CVS Health (08/08/25)
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  • Medical Director - OneHome

    Humana (Frankfort, KY)
    …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services… more
    Humana (07/15/25)
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  • Medical Director - South Central

    Humana (Frankfort, KY)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
    Humana (07/11/25)
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  • Medical Director - NorthEast Region

    Humana (Frankfort, KY)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (07/25/25)
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