- 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. 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
- CVS Health (Annapolis, MD)
- …and affordable. **Position Summary** As the Manager, FP&A, you will report directly to Director of Finance and will monitor the end to end profit & loss statements, ... data submission for the purpose of rate setting and medical trend analysis on behalf of the Health Plan....nature of this remote role, candidates must have some Medicare and/or Medicaid experience. **Required Qualifications** -5 or more… more
- 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 ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Evolent (Annapolis, MD)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Annapolis, MD)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , you will be a key member of the utilization management team. ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- CVS Health (Annapolis, MD)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
- Johns Hopkins University (Baltimore, MD)
- …relationships with government agencies and agents, in particular with the local Medicare carrier and fiscal intermediary medical directors and their respective ... as a medical billing and coding professional. Classified Title: Sr. Director Compliance & Training Job Posting Title (Working Title): Sr. Director … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Director , ACA Individual provides leadership for the operation of the ACA Individual programs across multiple ... ensure the profitability, growth, and stability of the business. The Director will have responsibility for business direction, financial performance, growth… more
- Humana (Annapolis, MD)
- …of our caring community and help us put health first** The Associate Director , Actuarial provides actuarial support across a broad range of actuarial and business ... needs for specific product lines. The Associate Director , Actuarial requires a solid understanding of how organization capabilities interrelate across department(s).… more
- Takeda Pharmaceuticals (Annapolis, MD)
- …to the best of my knowledge. **Job Description** **Regional Account Director ** **Takeda Pharmaceutical** **USA-MA-Virtual** **About the role:** Are you looking for ... you to shine? Join us as the Regional Account Director ; reporting into the Head of Corporate Accounts. This...accounts. Responsible for all books of business - Commercial, Medicare , State Medicaid and Managed Medicaid + Gain, protect… more
- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and ... and unstructured data to insights at enterprise scale. The Associate Director , Cloud Architecture requires an in-depth understanding of how organization capabilities… more
- Baylor Scott & White Health (Annapolis, MD)
- …adjudicated claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and ... Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support...Baylor Scott & White Quality Alliance Commercial, DTE, and Medicare (MSSP ACO, Medicare Advantage) lines of… more
- Humana (Annapolis, MD)
- …in the country. **Location:** remote The Insurance Strategy team supports Humana's Medicare and Medicaid lines of business. This business unit, Humana's largest, ... strategy for the business unit, evolving key dimensions of the Medicare Advantage growth strategy, developing a refreshed membership acquisition strategy, assessing… more
- Genesis Healthcare (Bowie, MD)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of...in the state of practice 3. Thorough knowledge of Medicare and third party billing required 4. Must have… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** **Regional Director of Clinical Operations** **Location:** Silver Spring, MD **About the Role** The ... **Regional Director of Clinical Operations** provides leadership and strategic direction...operations. + Knowledge of state and federal regulations and Medicare Conditions of Participation. + Experience with Joint Commission… more
- Humana (Annapolis, MD)
- …organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises ... experience leveraging core consulting skills to support delivering some of Medicare and Medicaid's highest priority projects and initiatives, with an emphasis… more
- CareFirst (Baltimore, MD)
- …years clinical and administrative experience in a managed care setting. + Previous experience as medical director for a health care company. + At least 5 years ... ** Medical Policy and Utilization Management Infrastructure** + Oversees the Medical Policy team and adoption of national standard, evidence-based clinical… more
- Johns Hopkins University (Baltimore, MD)
- …requirements. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all ... of Medicine's Quality Assurance Compliance Program. Prepares reports for the Senior Director , Director , and clinical departments regarding the status or results… more