- Humana (Columbus, OH)
- …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other… more
- Humana (Columbus, OH)
- …of established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be passionate about ... and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims...outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time… more
- CVS Health (Columbus, OH)
- …Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy implementation. ... ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied medical services.… more
- CVS Health (Sacramento, CA)
- …medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental ( Medicare /Medicaid) programs and individual client ... Director UM decisions. If specifically assigned to one business segment (ie, Medicare clients), each director will become sufficiently skilled in various UM… more
- Humana (Columbus, OH)
- … Inpatient Guidelines** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. +… more
- Humana (Columbus, OH)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. +… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …to achieve priorities for engagement with key customers and external groups including Commercial Payers, Medicare , Medicare Advantage plans, Part D, PBM's, ... evidence, and creating hope for all facing illness. The Director , Corporate Accounts, is a field based national leader...expansion of access and continued policy improvements in + Medicare and Commercial books of business. +… more
- Kedrion Biopharma (Fort Lee, NJ)
- …with specific attention to month-end, quarterly, year-end, forecasting and budget time. The Commercial Controller reports into the FP&A Director (US) and is ... The ** Commercial Controller** is a key role within the...supporting cash forecasting) and analysis services to the FP&A Director (US), Group FP&A in Italy and to the… more
- Arvinas (New Haven, CT)
- …Arvinas relationship and engagement with targeted regional and national payers including Commercial , Medicare and Medicaid payers. Support non targeted payers as ... Summary** As an important member of the Arvinas Market Access Team, the ** Director , Payer Accounts** will be a key contributor to a strong National Accounts… more
- Ascendis Pharma (Princeton, NJ)
- …the administration of rebate programs, including government rebates (eg, Medicaid, Medicare ), managed care rebates, and commercial rebates. Ensure accurate ... reimbursement models, and contracting strategies across various payer segments (eg, commercial , Medicare , Medicaid). + Excellent negotiation, communication, and… more
- The Arc Erie County NY (Williamsville, NY)
- …rules and regulations of oversight agencies and funding sources, including DOH, Medicare , Medicaid, and commercial insurance companies. Interprets policy and ... The Arc Erie County is looking for an Associate Director of Clinical Treatment Who we are: A local...+ Assuring compliance with DOH, CMS, OPWDD, NYSED, OMIG, commercial insurance providers regulations and guidelines + Monitoring all… more
- State of Colorado (Denver, CO)
- Director , Division of Aging and Adult Protective Services Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4598893) Apply Director , ... for Senior Services (SFSS). Description of Job This position functions as the director and highest program manager for the Division of Aging and Adult Protective… more
- LifePoint Health (Rutherfordton, NC)
- …and knowledge and experience operating community hospitals and healthcare organizations. The Director of Case Management is responsible for the oversight of Case ... Geometric Length of Stay (GLOS) for each patient. *Essential Functions: * The Director is responsible for the overall direction and management of these areas,… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …objectives with assigned specialty distributor and specialty pharmacy accounts. The Associate Director of Trade will collaborate with members of Supply Chain, ... Commercial , and corporate functions to achieve individual, group, and...and experience in different access and reimbursement models, including Medicare Parts B and D, Medicare Advantage… more
- CVS Health (Springfield, IL)
- …business, is a strategic partner in value-based care serving more than 1M Medicare beneficiaries, and over 60K provider partners across 230 clients in ACO REACH, ... Medicare Shared Savings Program (MSSP), and Medicare ...administrative support. CVS Accountable Care is seeking an Executive Director , Payor Medical Economics to join our growing organization.… more
- Ascension Health (Austin, TX)
- …two Accountable Care Organizations participating in the Enhanced Track of the Medicare Shared Savings Program, multiple commercial value-based models and a ... Ascension Texas has an immediate opening for a Medical Director of Population Health who will serve as a...(MD) or Doctor of Osteopathy (DO) or Doctor of Dental Surgery (DDS) or Doctor of Dental … more
- Arvinas (New Haven, CT)
- …specialty pharmacy. + Understanding of Benefit Design & Economics associated with Commercial , Medicaid and Medicare reimbursement for oral drugs with Oncology ... member of the Market Access Leadership team, the Senior Director , US Pricing & Contracting Strategy will lead the...serves as the functional lead for all Arvinas's US Commercial and Government Contracting & Pricing. They will be… more
- CVS Health (Carson City, NV)
- …based agreements. Value based contracting experience across all segments including commercial , Medicare Advantage, and Medicaid. Preferred location: Arizona ... more personal, convenient and affordable. **Position Summary** The Lead Director of value based contracting and business development is...will also develop a strong rapport with the Chief Medicare Officer and support the market Medicare … more
- CVS Health (New York, NY)
- …in support of business strategies across multiple lines of business, including Medicare Advantage, Medicaid, ACA, and Commercial . + Develops relationships with ... convenient and affordable. **Position Summary** Aetna is recruiting for a Lead Director , National VBS Development who will develop innovative and strategic provider… more
- CVS Health (Bloomington, MN)
- …negotiations on high-value medical rebate contracts and value based agreements for Medicare Part B, Managed Medicaid, and Commercial segments. This includes ... lowering costs and improving quality of care. In this Director level role, you will have the opportunity to...understanding of pharmaceutical medical rebates, buy and bill, and/or Medicare Part B benefit designs + Familiarity with ASP… more