- Humana (Annapolis, MD)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- CommuniCare Health Services Corporate (Linthicum Heights, MD)
- …posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management , and others. The CBO claims validation staff will strive to always ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...of benefit options from life and disability plans to medical , dental, and vision coverage from quality benefit carriers.… more
- Humana (Annapolis, MD)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Annapolis, MD)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Merck (Annapolis, MD)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Western Digital (Annapolis, MD)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
- University of Maryland, Baltimore (Baltimore, MD)
- …of Maryland Baltimore (UMB) invites applications from dynamic, customer-focused Construction Project Management Leaders to serve as its Associate Director of ... Project Management .*Reporting to the Executive Director of Design and Construction, the successful candidate will lead UMB non-capital campus construction,… more
- Humana (Annapolis, MD)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- CareFirst (Baltimore, MD)
- …based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the utilization ... for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach to enhance member engagement,… more
- HomeSafe Alliance (Annapolis, MD)
- **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
- Baylor Scott & White Health (Annapolis, MD)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
- CareFirst (Baltimore, MD)
- … management , interpreting dental/ medical policy, quality improvement, disease management , utilization review, and dental/ medical claims review, ... leadership experience **Experience:** 8 years experience in dental health care or medical management . 3 years management experience. **Preferred… more
- Takeda Pharmaceuticals (Annapolis, MD)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- BD (Becton, Dickinson and Company) (Sparks, MD)
- …Description** We are **the makers of possible** BD is one of the largest global medical technology companies in the world. Advancing the world of health (TM) is our ... with us. **Job Responsibilities:** _(Primary Duties, Roles, and/or Authorities)_ **Warehouse Management ** : + Oversee the operations of the warehouse, ensuring… more
- Evolent (Annapolis, MD)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
- Evolent (Annapolis, MD)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Prime Therapeutics (Annapolis, MD)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
- Johns Hopkins University (Middle River, MD)
- …efficient claims processing. + Requires a thorough understanding of medical billing and the unique customer service requirements as related to patients, ... consultation, and reports to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS). Reviews provider income… more
- Prime Therapeutics (Annapolis, MD)
- …) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical , and/or financial data + Basic to intermediate SAS coding ... adjust focus **Reporting Structure** + Reports to Manager or Director in the Network Management , Consulting Analytics...to Manager or Director in the Network Management , Consulting Analytics or Operations & Planning department Potential… more