• Medical Director - Payment…

    Humana (Washington, DC)
    **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
    Humana (09/26/25)
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  • Director of Payment Integrity…

    CGI Technologies and Solutions, Inc. (Charlotte, NC)
    ** Director of Payment Integrity Consulting** **Category:** Finance **Main location:** United States, Georgia, Atlanta **Alternate Location(s):** United ... Consulting & Solution Development: * Conduct comprehensive assessments of client payment integrity programs, identifying areas for improvement, efficiency gains,… more
    CGI Technologies and Solutions, Inc. (09/25/25)
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  • Director Payment Integrity

    Providence (Portland, OR)
    …This position can be based in Portland, OR Seattle, WA or Irvine, CA. The Director of Payment Integrity (PI) is responsible for overseeing the strategy, ... execution, and optimization of enterprise-wide payment integrity initiatives. You will ensure accurate...propose and prioritize new PI initiatives. + Collaborate with medical policy, analytics, compliance, IT, and claims teams to… more
    Providence (09/27/25)
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  • Director , Financial Planning & Analysis…

    Mastercard (Harrison, NY)
    …people, businesses and governments realize their greatest potential._ **Title and Summary** Director , Financial Planning & Analysis - Commercial & New Payment ... where strategic finance meets executive leadership. Commercial and New Payment Flows (CNPF) is Mastercard's strategic organization focused on...reach and impact in the evolving payments landscape. As Director of FP&A, you will play a pivotal role… more
    Mastercard (09/11/25)
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  • Medical Director

    HCA Healthcare (Nashville, TN)
    …of care in 21 states and the United Kingdom. We are looking for a Medical Director for our Work from Home team where excellence creates excellence. **Benefits** ... recent years. Do you want to be an influencer in healthcare? **Apply for our Medical Director role today!** **Job Summary and Qualifications** The Medical … more
    HCA Healthcare (09/27/25)
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  • Manager, Medical Director…

    Elevance Health (New Hyde Park, NY)
    …preferred. + Experience advising medical cost management, utilization management, payment integrity , or provider performance programs preferred. + Strong ... **Manager, Medical Director - Transformation Initiatives** Location:...Decisioning & Analytics (RDA)** + **Cost of Care / Payment Integrity ** + **Care Management / Utilization… more
    Elevance Health (10/04/25)
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  • Medical Director - SIU (Special…

    CVS Health (CA)
    …to safeguard healthcare integrity and protect patient well-being. As the Medical Director of Healthcare Fraud Investigations, you'll lead our efforts to ... do it all with heart, each and every day. Medical Director - SIU (Special Investigations Unit)... will be responsible for making both pre and post- payment claim payment determinations based on Aetna… more
    CVS Health (10/01/25)
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  • Director , B2B Partnerships Acceptance

    Mastercard (Harrison, NY)
    …* The Director will build direct relationships acquiring bank and payment facilitators to support our B2B partner acceptance needs - including solution design, ... and governments realize their greatest potential._ **Title and Summary** Director , B2B Partnerships Acceptance Director , B2B Partnerships...structure, and go to market plans that will drive payment volumes and revenue. * Does delivering on a… more
    Mastercard (09/14/25)
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  • Medical Director , Psychiatry…

    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 (08/09/25)
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  • Medical Director , Commercial Line…

    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
    Excellus BlueCross BlueShield (09/30/25)
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