- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …you, we encourage you to apply! Job Description: This position assists the Chief Medical Director to direct and coordinate the medical management, quality ... performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals...or unusual or new services in order to determine medical necessity and appropriate payment . + Develops… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... and medical criteria. + Assists with training medical director colleagues and nursing staff ,...changes in healthcare. + Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Medical Director will assist the VP Member Health and Chief Medical Officer ... in accordance with regulatory, accreditation, corporate policies and strategic plan. The Medical Director will participate in medical advisory committees,… more
- Mastercard (Harrison, NY)
- …businesses and governments realize their greatest potential._ **Title and Summary** Director , North America Franchise Innovation Overview: The Franchise model is the ... scale and driving innovation in traditional carded payments as well as new payment flows. Through this powerful business model, we ensure that everyday hundreds of… more
- Edwards Lifesciences (Raleigh, NC)
- …healthier lives. Join us and be part of our inspiring journey. The Director , Global Health Economics and Reimbursement is a field-based role responsible for working ... individual will also support the health care providers in obtaining optimal reimbursement ( payment rates and market access) by serving as a knowledgeable resource in… more
- Medical Express Ambulance Service (Skokie, IL)
- About Us: Medical Express Ambulance Service is committed to delivering exceptional patient care through professionalism, compliance, and operational excellence. We ... culture that values innovation, accountability, and continuous improvement. Position Summary:The Director of Revenue Cycle leads and optimizes all aspects of the… more
- Commonwealth Care Alliance (Boston, MA)
- …and effectively. * Represent Provider Network in collaborative forums and committees, including payment policy and medical policy. Other Duties * Develop and ... 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider… more
- RELX INC (Washington, DC)
- …lead our efforts with alliance and channel partners of our VitalChek and LexisNexis Payment Processing business. About the Job: The Director of Alliance and ... insights from complex data sets, improving operation efficiency, increasing program integrity , discovering, and recovering revenue, and making timely and informed… more
- UPMC (Pittsburgh, PA)
- …developing strategies across cross-functional teams such as Clinical, Network, Finance, and Payment Integrity , supporting the execution of those strategies, and ... evaluating program and initiative outcomes. The Director of Medical Cost Economics will manage one or more analysts and will require a diverse set of skills and… more