- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …Must demonstrate a high level of understanding of regulations related to promotion compliance . May be assigned additional responsibilities as deemed necessary. ... Must demonstrate a high level of understanding of regulations related to promotion compliance . May be assigned additional responsibilities as deemed necessary.… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- The Associate Director , Channel Analytics will be a key member of the Business Analysis team, responsible for leading marketing mix and channel analytics to ... of promotional investments across various channels (HCP, DTC, digital, non-personal promotion , etc.). + Develop and refine multi-touch attribution models and other… more
- CenterWell (Providence, RI)
- …training program for coding staff to ensure continuous skill development and compliance with coding standards. + Partner with analytics and audit to identify ... coder errors and develop plans to address deficiencies/specific areas of focus. ** Associate Engagement and Retention:** + Develop and implement strategies to foster… more
- Humana (Providence, RI)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Providence, RI)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Providence, RI)
- …part 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, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other… more
- Humana (Providence, RI)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Providence, RI)
- …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 scope and complexity...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Humana (Providence, RI)
- …experience for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals), you will be accountable for ... and/or other end compliant inquiries. + Has 6-7 direct reports including Associate Directors, Managers, and Senior Professionals + Provides strategic direction and… more
- Humana (Providence, RI)
- …us put health first** Humana is seeking a strategic and experienced Director of Business Performance Management, to lead the development, implementation, and ... Operations, this role will be pivotal in ensuring operational efficiency, effectiveness, compliance , and the achievement of key business objectives. The Director … more