- Molina Healthcare (Madison, WI)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- Robert Half Finance & Accounting (Eatontown, NJ)
- …located in Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare /Medicaid Reimbursement. + The Director will have advanced level ... partnership with the Vice President of Corporate Reimbursement, the Director will manage the completion of DSH, Medicare...Analyst(s) in completion of certain projects when assigned by senior management. + Prepares Medicare and Medicaid… more
- CVS Health (Boston, MA)
- …We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal ... candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a strong… more
- 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
- Humana (Lansing, MI)
- …first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes ... diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors… more
- Bristol Myers Squibb (Princeton, NJ)
- …personal lives. Read more: careers.bms.com/working-with-us . **Summary:** The Commercial & Medicare Channel Lead will manage forecasting and analytics for the ... Commercial and Medicare channels. This role coordinates inputs from various teams...Strong communication skills and ability to communicate succinctly to senior leaders + Intellectual curiosity and interest in continuous… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will ... key relationships throughout the organization including, but not limited to, Medicare Product, Provider Contracting, Health and Medical Management, Actuarial,… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight ... for all of Sharp Health Plan products, (Commercial, Exchange, Medicare , POS/PPO) services, and oversees the health care needs...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- Banner Health (Phoenix, AZ)
- …**Department Name:** Clinical Decision Making **Work Shift:** Day **Job Category:** Physicians The Senior Medical Director , Network Performance is a ... Through data-informed leadership, enterprise collaboration, and credible clinical engagement, the Senior Medical Director will ensure Banner's network… more
- Amneal Pharmaceuticals (Bridgewater, NJ)
- Description: The Senior Director of Market Access Strategy is responsible for the development and execution of the value and market access strategy and strategic ... and government channels in the US payer landscape. The Senior Director will be responsible for the...formulary access go-to-market strategies and executional plans across both medical and pharmacy benefits, as well as unique business… more
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