- Optum (Tuscumbia, AL)
- …by LHC Group. Is able to articulate competitive advantages, specialty programs, and Medicare guidelines. Educates the medical community about the services of our ... company market share through account development and educating the medical community on services provided by the company while...to follow the plan of care Presents agency Executive Director with identification of patient needs to obtain branch… more
- Humana (Lincoln, NE)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... a case by case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director will collaborate with clinicians and… more
- Humana (Chicago, IL)
- …a part of our caring community and help us put health first** The Director , Revenue Cycle Management for Humana Pharmacy will own the billing, collections ... and reporting for CenterWell Pharmacy & Specialty pharmacy and Humana ...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Elevance Health (Las Vegas, NV)
- **Clinical Pharmacy Account Director - Clinical Account Management** **Location:** This role requires associates to be in-office 3 days per week, fostering ... accommodation is granted as required by law. The **Clinical Pharmacy Account Director ** is responsible for building...data and experience in supporting commercial as well as Medicare business are essential, as are strong communication and… more
- Walmart (Bentonville, AR)
- **Position Summary ** As Director , Payer Programs (Rx Clinical Services), you will lead pharmacy clinical services contracting and payer relationship development ... how patients experience healthcare. **What you'll do ** + Direct pharmacy clinical services contracting by overseeing complex negotiations, governance structures,… more
- AmeriHealth Caritas (Detroit, MI)
- …and authorizations, including home- and community-based programs. + Collaborate with the Medical Director and care team to develop and monitor treatment ... the Medicare LTSS Care Coordinator manages care coordination for Medicare beneficiaries with complex medical , behavioral health, Long-Term Services &… more
- Henry Ford Health System (Traverse City, MI)
- …is required. GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 ... planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for both… more
- Penn Medicine (Philadelphia, PA)
- …each day. Are you living your life's work? Summary: + Penn Presbyterian Medical Center is seeking a full-time Clinical Pharmacy Specialist, Opioid Stewardship. ... of information technology for pharmacotherapy management.* Implement and maintain clinical pharmacy programs that support meeting Medicare Core Measures.… more
- State of Colorado (Denver, CO)
- PHARMACY TECHNICIAN II- CMHH at Fort Logan Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5163616) Apply PHARMACY TECHNICIAN II- CMHH at ... over six treatment milieus serving civil and forensic individuals. Medical services, occupational therapy, neuropsychological-rehabilitation services, and trauma-informed care… more
- Point32Health (MA)
- …support functions for the Pharmacy and Therapeutic's committee in collaboration with the pharmacy medical director . Leads and manages the work of the ... Point32Health (https://www.point32health.org/) . **Job Summary** Under the direction of the Director , Clinical Pharmacy Operations, the Senior Manager, Clinical … more
- CenterWell (Las Vegas, NV)
- …the lives of our patients, and the healthcare industry as a whole. The Associate Medical Director serves as a health-care professional and capable of handling a ... variety of health-related problems. The Associate Medical Director requires a solid understanding of...**Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Under direct supervision of the Director of Specialty Pharmacy , the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical ... with clinical employees on multiple levels, including pharmacists, nurses, medical /clinical staff, Finance personnel, department managers, access services staff, and… more
- Humana (Miramar, FL)
- …purchasing coordinator. + Performs other duties as assigned by direct supervisor, Sr. Pharmacy Director and/or Clinical Pharmacists **Use your skills to make an ... a part of our caring community and help us put health first** The Pharmacy Fulfillment Technician/ Care Management Support Assistant 2 works as a liaison between… more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Penn Medicine (Philadelphia, PA)
- …information technology for pharmacotherapy management. + Implement and maintain clinical pharmacy programs that support meeting Medicare Core Measures. ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
- Centene Corporation (Jefferson City, MO)
- …IRE and ALJ hearings, STARS metrics + Previous experience with ensuring high quality medical director training to review Medicare UM and appeals, Clinical ... plan leaders and cross functional stakeholders across the enterprise. + Provide medical leadership for all utilization management (appeals), pharmacy , case… more
- Gentiva (Milwaukee, WI)
- …Hospice and Palliative Medicine board certification and/or Hospice Medical Director Certification Board certification preferred. + Current Medicare Provider ... Transform Care through Compassionate Hospice Leadership.** We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. * Utilization management experience in a medical management review organization, such as Medicare … more
- UCLA Health (Los Angeles, CA)
- …Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Medical Director , Clinical Operations to help shape the future of our plan. ... this key leadership role, you'll work closely with the Medical Director , Department of Health Services and...to ensure high-quality, cost-effective care. + Collaborate with the Pharmacy team on safe, effective medication use; participate in… more
- Centene Corporation (Baton Rouge, LA)
- …a fresh perspective on workplace flexibility. **We're Hiring: Full-time Behavioral Health Medical Director ** Centene Corporation is a leading provider of ... and Neurology + 5+ years of post-residency experience **Position Purpose:** Assist the Sr Medical Director to direct and coordinate the medical management,… more
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