- CVS Health (Annapolis, MD)
- …And we do it all with heart, each and every day. **Position Summary** The Lead Director , Medicare Member Journey Orchestration Center of Excellence ... -related processes to advance a seamless, highly personalized engagement across our member 's unique journey. You will lead cross-functional governance processes… more
- CVS Health (Hartford, CT)
- …to drive real change and improve the health of millions are endless. As Lead Director , Enterprise Strategy, you play a pivotal role helping to shape ... team is looking for a dynamic and creative team member who is passionate about driving change across the...discussions + 3+ years of experience in healthcare payor, Medicare , Medicaid or provider consulting experience + 3+ years'… more
- Elevance Health (Miami, FL)
- **Medical Director - Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... Florida near our Miami or Tampa locations.** The **Medical Director ** will support the following Florida Medicare ...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Humana (Lansing, MI)
- …of diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead , plans, directs, and ... caring community and help us put health first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical… more
- Fallon Health (Foxborough, MA)
- …care and are continually rated among the nation's top health plans for member experience, service, and clinical quality. Fallon Health's NaviCare is a program for ... in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for ... Quality Assurance (NCQA) accreditation standards, as appropriate to the member 's case assignment. Uses a systematic approach to identify members meeting program… more
- Blue KC (MO)
- …adoption financial assistance** **Employee discount program** **Job Description Summary:** The Lead Medical Director actively uses their clinical training, ... of care, and/or requested site of service should be authorized. The Medical Director will apply various clinical policies, state and federal guidance, and contracts… more
- Humana (San Juan, PR)
- …within the Medicare Line of Business. **Additional Information** Typically reports to Lead or Corporate Medical Director , depending on size of region or line ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Lincoln, NE)
- …**Additional Information** Typically reports to a Regional Vice President of Health Services, Lead , or Corporate Medical Director , depending on size of region or ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and operational objectives. Reporting to the AVP of Revenue Finance and Analysis, the Director will lead a team of 4-5 individuals with expertise in both ... , Revenue Finance and Reimbursement, will be a core member of the Revenue Finance leadership team of Beth...revenue analysis. Working with the VP and AVP, the Director will develop long- and short- term Medicare… more