- Humana (Washington, DC)
- …our caring community and help us put health first** Humana Healthy Horizons is seeking an Associate Director , Medicaid Provider Services to serve in a ... and leading teams, and working in matrixed environments. The Associate Director , Medicaid Provider...subject matter expert on provider relations and provider engagement/performance improvement. + Provide oversight of… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range ... understanding of how organization capabilities interrelate across the function or segment. The Director , Actuarial of Medicaid Pricing may be responsible for any… more
- Humana (Washington, DC)
- …of our caring community and help us put health first** The Medical Director 's primary responsibility is the review of medical authorizations or claims to determine ... the medical necessity of a given service or level of care. The Medical Director 's work assignments involve moderately complex to complex issues where the analysis of… more
- Humana (Washington, DC)
- …community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...internal teaching conferences, and other reference sources * Learns Medicaid requirements and understands how to operationalize this knowledge… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Associate Director , Data Science uses mathematics, statistics, modeling, business analysis, and ... to transform high volumes of complex data into advanced analytic solutions. The Associate Director , Data Science requires a solid understanding of how… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Associate Director , Agile Coaching guides, educates, and mentors organizational leaders and ... and practices including Scrum, Kanban and Scaled Agile Framework (SAFe). The Associate Director , Agile Coaching requires a solid understanding of how… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Associate Director , Data Science uses mathematics, statistics, modeling, business analysis, and ... to transform high volumes of complex data into advanced analytic solutions. The Associate Director , Data Science requires a solid understanding of how… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Associate Director of Digital Experience Solutions (DES) Architecture In support of our ... goals, and to enable effectiveness and efficiency of technology decisions. The Associate Director of Digital Experience Solutions (DES) Architecture is a… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Associate Director , Security Architecture will play a key role in implementing security ... frameworks to ensure the enterprise can achieve the enterprise security strategy. The Associate Director , Security Architecture will play a key role in… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Associate Director , Enterprise API Standards and Governance is a pivotal role in leading ... be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet… more
- Guidehouse (Mclean, VA)
- …relationships, and delivering impactful project results within the Centers for Medicare & Medicaid Services (CMS). You will own the delivery of projects that aim to ... problem-solving, client service, and project management. **Job Description/Responsibilities** + Provide leadership and oversight of highly complex, multi-year awards… more
- Humana (Washington, DC)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Washington, DC)
- …**Additional Information** Typically reports to a Lead, may also report to a Regional/ Associate Vice President or Corporate Medical Director , depending on size ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Washington, DC)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Washington, DC)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex… more
- Humana (Washington, DC)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Must be passionate… more
- Humana (Washington, DC)
- …Best Places to Work, and be a part of our dynamic team as the Director of Technology Solutions. We are on a mission to revolutionize our Customer Relationship ... your chance to make a substantial impact! As the Director of Technology Solutions, you will spearhead the strategy...Effectively lead a high-performing team of associates consisting of Associate Directors, Lead Architects, Tech Leads, and more. +… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on building a ... AI techniques **Preferred Qualifications:** * Microsoft Certified: Azure Data Engineer Associate * Microsoft Certified: Azure AI Fundamental * Microsoft Certified:… more
- Public Consulting Group (Washington, DC)
- …support the delivery of health-related services by helping schools access critical Medicaid reimbursement. Client Success Partners (CSP) are key members of the ... PCG services. This position may report to either a SBS COE Client Success Director or a Client Success Lead. **Duties and Responsibilities** _Clients_ + Own and… more
- Evolent Health (Washington, DC)
- …outreach, and administrative auditing. This position reports to the Associate Director , Credentialing Operations. **Collaboration Opportunities:** The ... Operations will be a dynamic role that will encompass determining provider types who require credentialing, initiating the Primary Source Verification Process… more