- Merck & Co. (North Wales, PA)
- …work model is combination of in-office and work from home) The Associate Director Market Access will work closely with agency partners, internal brand colleagues, ... and launch future mono-therapies and combination.- This role will report to the Director , Oncology Market Access. The Associate Director Market Access will be… more
- Novo Nordisk Inc. (WA)
- …potential? This role can sit in Plainsboro, NJ or Washington, DC. The Position The Director - US Tax, Trade, IP works on complex issues that will require an in-depth ... globally. Relationships Reports to the Market Access and Public Affairs Senior Director , Policy. Other internal relationships include a dotted line with Corporate… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …Market Access & Public Affairs (MAPA) Channel Strategy Team, reporting to Director , Market Access Medicare Strategy. Interacts frequently in collaboration with ... delivers an understanding of landscape, changes, and trends in the Commercial, Medicare , and Medicaid channels across all NNI therapeutic areas. Collects, analyzes,… more
- CVS Health (Salem, OR)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals: * Direct daily work on part ... encumbrances * Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals… more
- Humana (Columbus, OH)
- …analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides ... caring community and help us put health first** The Medical Director relies on medical ...or Surgery specialties + Utilization management experience in a medical management review organization, such as Medicare … more
- Elevance Health (Columbus, OH)
- ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Molina Healthcare (San Bernardino, CA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- ChenMed (New Orleans, LA)
- …preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board ... preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to manage a… more
- Humana (Columbus, OH)
- …and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation... Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify … more
- CVS Health (New Albany, OH)
- …is compliantly and effectively operating in the market. As such, the Lead Director of Medicare Operations supports MAPD and SNP initiatives and implements ... personal, convenient and affordable. **Position Summary** In support of the Chief Medicare Officer, the candidate has responsibility for ensuring that the local … more
- CVS Health (Hartford, CT)
- …make health care more personal, convenient and affordable. **Position Summary** As the Medicare Reporting Lead Director , you will be responsible for the ... of monthly, quarterly, and annual financial results for the Medicare segment. This role will allow you to own...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Cleveland Clinic (Cleveland, OH)
- Director Medicare Coverage Analysis Join Cleveland Clinic's Main Campus where research and surgery are advanced, technology is leading-edge, patient care is ... work collaboratively with the institutes and research billing office to create a Medicare coverage analysis billing grid for research studies with a patient care… more
- CVS Health (Hartford, CT)
- …in new and exciting ways every day. Aetna is recruiting for an Executive Director , Sales & Account Management for Aetna's Medicare Senior Supplemental Insurance ... of the sales team. This pivotal role drives growth across Medicare Supplement and Ancillary products through National Marketing Organizations (NMOs), strategic… more
- Elevance Health (Wallingford, CT)
- ** Medicare Star Strategy & Program Development Director ** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will ... our Elevance Health PulsePoint locations. The **Strategy & Program Development Director ** is responsible for responsible for coordinating the relationship and… more
- UCLA Health (Los Angeles, CA)
- …of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is instrumental in participating in the planning with the ... director and other functional areas for implementation and execution...throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David… more
- Banner Health (AZ)
- …government programs, member retention, network administration, and medical management administration departments. Responsible for ensuring cross-organizational ... a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and… more
- CVS Health (Blue Bell, PA)
- …skills and attention to detail **Preferred Qualifications** + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience with SAS, SQL, ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- University of Miami (Miami, FL)
- …when necessary + Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population ... evaluations. This role also works directly with staff, administration, medical directors, and other relevant stakeholders to assure appropriate...preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of… more
- AdventHealth (Altamonte Springs, FL)
- …and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital ... of work papers for the filing of the annual Medicare , Medicaid, and Champus/Tricare cost reports, audit preparation and...Complete special projects assigned by the department manager or director within the time frame requested **The expertise and… more
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