• Medical Director - Medicare

    CVS Health (Sacramento, CA)
    …of covered benefits in the Commercial and Medicare environment with a focus Medicare policy., This Medical Director provides subject matter expertise in ... day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a… more
    CVS Health (10/19/25)
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  • Behavioral Health Medical Director

    Humana (Helena, MT)
    …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...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare more
    Humana (11/11/25)
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  • Medical Director - Nat'l OP…

    Humana (Columbus, OH)
    **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 (12/04/25)
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  • Medical Director - Medicare

    CVS Health (Hartford, CT)
    …(work at home) based anywhere in the US. **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part ... * Board Certified in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience. *… more
    CVS Health (12/03/25)
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  • Medical Director , Medicare

    Humana (Honolulu, HI)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
    Humana (11/19/25)
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  • Lead Director ; Actuarial - Medicare

    CVS Health (Blue Bell, PA)
    …in this role will serve as the subject matter expert for Aetna's Medicare Advantage Special Needs Plans (SNP) business. Includes Dual Eligible, HIDE/FIDE Integrated, ... and Chronic plans. The SNP population presents a huge growth opportunity for Medicare Advantage plans, and Aetna is aggressively expanding into this market. This… more
    CVS Health (10/22/25)
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  • Medicare Annual Wellness Visit Registered…

    SUNY Upstate Medical University (Syracuse, NY)
    …and Practice Operations and collaborate closely with Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare ... Job Summary: Position Summary: Upstate University Medical Associates at Syracuse Inc. (UUMAS) is seeking...or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care… more
    SUNY Upstate Medical University (11/26/25)
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  • Senior Medicaid & Medicare Reimbursement…

    OhioHealth (Columbus, OH)
    …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… more
    OhioHealth (09/25/25)
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  • Medicare /Medicaid Claims Editing…

    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 ... reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance, Payment Integrity and Analytics… more
    Commonwealth Care Alliance (11/25/25)
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  • Medicare Sales Field Agent…

    Humana (Miami Lakes, FL)
    …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
    Humana (10/04/25)
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