• Lead Director , Senior

    CVS Health (Columbus, OH)
    …make health care more personal, convenient and affordable. **Position Summary** The Medicare Performance Management Lead Business Consultant will facilitate and ... Medicare Advantage market and segment leadership teams. The Lead Business Consultant role will be a liaison between... Business Consultant role will be a liaison between senior management and local market leaders Identifies and leads… more
    CVS Health (10/11/24)
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  • Senior Director , Medicare

    Somatus (Mclean, VA)
    …+ Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation ... ensure program compliance with governing bodies' regulations, including the Center for Medicare and Medicaid Services. This role will partner with leadership to… more
    Somatus (10/09/24)
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  • Medicare Provider Performance Enablement…

    The Cigna Group (Atlanta, GA)
    …Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director , this individual ensures the effective ... network for his/her assigned sub-market and/or provider groups. The role of Senior Advisor with the Provider Performance Enablement team takes ownership for… more
    The Cigna Group (08/27/24)
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  • Senior Director Clinical Programs…

    Martin's Point Health Care (Portland, ME)
    …certified as a "Great Place to Work" since 2015. Position Summary The Senior Director Clinical Programs provides oversight and coordination of care management ... activities, objectives, and analysis for the Martin's Point Health Plan. The Senior Director is responsible for Care Management design, implementation and… more
    Martin's Point Health Care (08/20/24)
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  • Senior Medical Director , Centers.

    ChenMed (Detroit, MI)
    …is a transitional position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical ... organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a...to increasingly assume the role and responsibilities of a Senior Medical Director , which may include: +… more
    ChenMed (08/28/24)
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  • Senior Director of Payor Relations

    Monte Nido (Miami, FL)
    …as the Senior Director of Payor Relations. The Senior Director of Payor Relations will lead the development, negotiation, and management of payor ... lives while providing the opportunity for people to realize their healthy selves. ** Senior Director of Payor Relations** **Monte Nido & Affiliates** **Nashville,… more
    Monte Nido (10/10/24)
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  • Director / Senior Director

    ConvaTec (Bridgewater, NJ)
    …all the time. We're a business that never stands still. Join the team as the Director / Senior Director , US Policy and Global Market Access and Reimbursement - ... AWC portfolio by optimizing reimbursement pathways globally and (2) Lead Convatec in ensuring optimal US reimbursement policies, especially...note, this position could be hired at either a Director or Senior Director level… more
    ConvaTec (08/28/24)
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  • Lead Director Part D Member…

    CVS Health (Hartford, CT)
    …to make health care more personal, convenient and affordable. **Position Summary** As the Lead Director , Medicare Part D Member Experience you will ... a team to develop cross-functional solutions to address Medicare Advantage Part D member experience opportunities, resulting in...stakeholders across the entire CVS Health enterprise. As the Lead Director , you will take collaboration to… more
    CVS Health (10/10/24)
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  • Senior Medical Director , Health…

    CVS Health (Lansing, MI)
    …solutions to make health care more personal, convenient and affordable. **Position Summary** The Senior Medical Director , Health Equity will report to the VP and ... and implementation of health equity into programs, products, and services. The Senior Medical Director will also support successful engagement with internal… more
    CVS Health (07/22/24)
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  • Senior Director , US Pricing…

    Arvinas (New Haven, CT)
    …As a key member of the Market Access Leadership team, the Senior Director , US Pricing & Contracting Strategy will lead the function developing and executing ... of Arvinas's portfolio. This position serves as the functional lead for all Arvinas's US Commercial and Government Contracting...role include, but are not limited to: + Provides senior management and cross functional team members with relevant… more
    Arvinas (08/13/24)
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  • Senior Director of HEMAR, Image…

    Philips (Plymouth, MN)
    ** Senior Director of HEMAR, Image Guided Therapy** The Image Guided Therapies (IGT) Systems and Devices HEMAR leader will provide vision and strategic leadership ... payer coverage and sustainable payments for business unit products. The leader will lead a team of professionals. **Your role:** + Establish the overall strategy and… more
    Philips (10/10/24)
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  • Senior Medical Director , Behavioral…

    Magellan Health Services (Albuquerque, NM)
    … and Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health care by ... assurance and continuous quality improvement (CQI) processes. General Job Information Title Senior Medical Director , Behavioral Health - New Mexico Grade 37… more
    Magellan Health Services (10/02/24)
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  • Lead Director - Retention…

    CVS Health (Hartford, CT)
    …to make health care more personal, convenient and affordable. **Position Summary** As the Lead Director , Retention Performance Advisory, you will lead a team ... to develop cross-functional solutions to address Medicare Advantage member retention opportunities, resulting in initiatives that significantly impact organizational… more
    CVS Health (10/10/24)
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  • Lead Director - Actuarial (Plan…

    CVS Health (Overland Park, KS)
    …reports on these issues. **A Brief Overview** The primary responsibility of this director role will be leading Actuarial market support for the Central region's ... (IL, KS, MI, OK). Within this role, you'll: + Lead /manage Plan and analytical support to achieve operating plan...from a business perspective and be able to influence senior management to accept alternative recommendations. (5% time) +… more
    CVS Health (10/11/24)
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  • Director , Claims Modernization, Claims…

    Healthfirst (NY)
    …setting departmental strategy, communicating, and influencing impact and progress to senior leadership + Experience with Medicare /Medicaid and Commercial ... with key stakeholders, with experience communicating and influencing at the senior leadership level. + Successful track record developing creative, workable… more
    Healthfirst (10/04/24)
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  • Medical Director - Clinical Services

    CareOregon (Portland, OR)
    …in the provider network. Essential Responsibilities + In partnership with the Senior Medical Director and/or other Medical Directors, develop, implement, and ... Aim. Direct support may be focused on Medicaid or Medicare lines of business in a Coordinated Care Organization...and appeals for medical and pharmacy as assigned by Senior Medical Director or CMO. + May… more
    CareOregon (09/19/24)
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  • Director , Utilization Management

    Point32Health (Canton, MA)
    …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, leading, and ... Services, Inpatient & Outpatient) for Point32Health's lines of business. The Director is responsible for ensuring achievement of Point32Health corporate goals;… more
    Point32Health (08/01/24)
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  • Reporting and Analytics Director

    Elevance Health (Norfolk, VA)
    **Reporting and Analytics Director - CAHPS/STARS** **Location:** This position will work a hybrid model (remote and in office one day per week). Ideal candidates ... KY, Wilmington, DE, Tampa, FL or Nashville, TN. The **Reporting and Analytics Director - CAHPS/STARS** is responsible for high-priority analytical projects for the … more
    Elevance Health (09/18/24)
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  • Director , Contracting Operations - Job ID:…

    Ascendis Pharma (Princeton, NJ)
    …in Princeton, NJ three (3) days/week and will report directly to the Senior Director , Pricing and Contracting Strategy. Key Responsibilities: + Contract ... develop their skills. Ascendis Pharma is looking to hire an experienced Director , Contract Operations to join our team. Responsibilities will include implementing… more
    Ascendis Pharma (10/10/24)
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  • Medical Director (Behavioral Health)…

    Magellan Health Services (Honolulu, HI)
    …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. ... the health plan(s) for all lines of business (Medicaid, Medicare , and Commercial) and implements programs to support this...various committees or project teams as directed by the senior medical director or vice-president. + Supports… more
    Magellan Health Services (09/25/24)
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