- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Annapolis, MD)
- …a part of 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Annapolis, MD)
- **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...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new ... and work is performed without direction. The Behavioral Health Medical Director actively uses their medical...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- CenterWell (Annapolis, MD)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic...and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare … more
- CenterWell (Annapolis, MD)
- **Become a part of our caring community and help us put health first** ** National ** ** Director of Transitional Care and High-Risk Patient Management** The ... Director of Transitional Care and High-Risk Patient Management (TCM...consistent with PCO Strategic Initiatives. * Formulate and achieve national objectives, goals, and strategies (clinical, economic), integrate practice… more
- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Associate Director , Acquisition Integration performs project-oriented duties related to the integration of an ... acquired entity into the company. The Associate Director , Acquisition Integration requires a solid understanding of how organization capabilities interrelate across… more
- Prime Therapeutics (Annapolis, MD)
- …legislative/oversight bodies (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA- National Committee for ... passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description Summary**… more
- Humana (Annapolis, MD)
- …us put health first** Humana's Marketing Organization is seeking an Associate Director , Sales Enablement Technology to join the Retail Marketing team working remote ... the end-to- end agent and market leader experience. As the Associate Director , Sales Enablement Technology, you will plan, recommend, implement, and optimize market… more
- Sumitomo Pharma (Annapolis, MD)
- …highly motivated, and experienced individual for the position of **Senior Director , Pricing, Contracting Strategy & Analytics.** This position reports to the ... **Vice President, Strategic Pricing & Contracting** . The **Senior Director , Pricing, Contracting** Strategy & Analytics will have primary responsibility for… more
- Evolent Health (Annapolis, MD)
- …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial utilizes and develops analytical tools to solve complex ... value-based care arrangements with government and commercial payors, including medical expenses, risk scores, benchmark/premiums, attribution, and (Incurred but not… more
- Cardinal Health (Annapolis, MD)
- The Director , Channel Development Strategy- Diabetes for Cardinal Health's at-Home Solutions is responsible for providing enhanced relationship management for ... supply chains across public and private sectors, specifically including Medicare DMEPOS reimbursement landscape. + Comprehensive communication and negotiating skills… more
- Humana (Annapolis, MD)
- …your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including ... are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. **Equal… more
- CenterWell (Annapolis, MD)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Highmark Health (Annapolis, MD)
- …overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures ... disease management identification process, and consult with the Organization's Associate Medical Directors and Medical Directors when appropriate, follow-up on… more
- Mathematica (Annapolis, MD)
- …entity such as Medicaid director , disability services director , deputy director for programs, chief finance officer, chief medical officer, chief public ... is based on evidence; lead technical teams as project director or subject matter expert; assure quality by performing...work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts… more
- Prime Therapeutics (Annapolis, MD)
- …of utilization management decisions. + On a requested basis, may function as Medical Director for select health plans or regions, assuming overall accountability ... member of the utilization management team, and provides timely medical review of service requests that do not initially... Affairs. + Other duties as assigned. **Responsibilities** + Medicare Part D experience preferred. + Doctor of Medicine… more
- Humana (Annapolis, MD)
- …You will report to the Product Marketing Patient Engagement and Retention Associate Director . **Key Role Functions** + Drive the activation of PCO's value story in ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more