• Medical Director Medicaid

    Humana (Jefferson City, MO)
    **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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
    Humana (01/18/26)
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  • Medical Director - Medicaid…

    CVS Health (MO)
    …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California,...Better Health Plan of Oklahoma. This UM (Utilization Management) Medical Director will be a "Work from… more
    CVS Health (01/16/26)
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  • Associate Center Clinical Director

    ChenMed (St. Louis, MO)
    …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
    ChenMed (10/28/25)
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  • Medical Director - IP Claims…

    Humana (Jefferson City, MO)
    **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 (12/11/25)
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  • Medical Director -Payment Integrity

    Humana (Jefferson City, MO)
    **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 (12/11/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Jefferson City, MO)
    …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
    Humana (11/15/25)
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  • Behavioral Health Medical Director

    Humana (Jefferson City, MO)
    …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...internal teaching conferences, and other reference sources + Learns Medicaid requirements and understands how to operationalize this knowledge… more
    Humana (01/13/26)
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  • Grievances and Appeals Corporate Medical…

    Humana (Jefferson City, MO)
    …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the ... and determining the best course of action. The Corporate Medical Director provides medical interpretation...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
    Humana (01/18/26)
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  • Field Medical Director , Cardiology

    Evolent (Jefferson City, MO)
    …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person"… more
    Evolent (12/31/25)
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  • Field Medical Director…

    Evolent (Jefferson City, MO)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person"… more
    Evolent (12/18/25)
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