- CVS Health (Phoenix, AZ)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... encumbrances * Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals… more
- Molina Healthcare (Phoenix, AZ)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director will collaborate with clinicians and support staff… more
- Humana (Phoenix, AZ)
- **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 (Phoenix, AZ)
- **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
- Humana (Phoenix, AZ)
- **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
- Evolent Health (Phoenix, AZ)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- CVS Health (Phoenix, AZ)
- …transformation, and administrative support. CVS Accountable Care is seeking an Executive Director , Payor Medical Economics to join our growing organization. In ... business, is a strategic partner in value-based care serving more than 1M Medicare beneficiaries, and over 60K provider partners across 230 clients in ACO REACH,… more
- BAYADA Home Health Care (Glendale, AZ)
- …is seeking a ** Director ** to fill the position of a **Home Health Director ** for our Medicare -certified home health office in **Glendale, AZ** . This office ... Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with...deposit and employee assistance program **As a Home Health Director your day may look like this!** + Lead,… more
- Community Health Systems (Tucson, AZ)
- …of operational, financial, programmatic and personnel activities for GME and Medical Staff Administration working with the GME programs. This includes establishing, ... records necessary for GME reimbursement as mandated by the Center for Medicare and Medicaid Services (CMS) * Represent the organization at professional conferences… more
- Humana (Phoenix, AZ)
- …us put health first** Humana Healthy Horizons is seeking an Associate Director , Medicaid Implementation (Business Project Management) to lead within a specific ... and project management are best suited for this role. The Associate Director , Medicaid Implementation (Business Project Management) will provide oversight to the… more
- Humana (Phoenix, AZ)
- …caring community and help us put health first** The Associate Director , Actuarial Analytics/Forecasting analyzes and forecasts financial, economic, and other data ... medium and long-term financial and competitive position. The Associate Director , Actuarial Analytics/Forecasting requires a solid understanding of how organization… more
- CVS Health (Phoenix, AZ)
- …convenient and affordable. **Position Summary** Aetna is recruiting for a Lead Director , National VBS Development who will develop innovative and strategic provider ... support of business strategies across multiple lines of business, including Medicare Advantage, Medicaid, ACA, and Commercial. + Develops relationships with… more
- CVS Health (Phoenix, AZ)
- …health care more personal, convenient and affordable. **Position Summary** The Lead Director of value based contracting and business development is responsible for ... will also develop a strong rapport with the Chief Medicare Officer and support the market Medicare ...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- Humana (Phoenix, AZ)
- …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
- Brookdale Senior Living (Phoenix, AZ)
- …revenue for assigned Brookdale communities with open Sales and Marketing Director positions. Prioritizes the outperformance of budgeted sales goals and community ... including but not limited to availability, pricing, and concessions. + Partners with Director (s) of District Sales to develop and execute business plans to achieve… more
- Prime Therapeutics (Phoenix, AZ)
- …passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary** ... Responsible for support and development of Medical Pharmacy program strategy as part of the Medical Pharmacy Business Development team. Responsible for managing… more
- Humana (Phoenix, AZ)
- …of our caring community and help us put health first** The Director , Technology Solution Implementation delivers new technological solutions to meet business needs ... within a specified scope while aligned to enterprise objectives. The Director , Technology Solution Implementation requires an in-depth understanding of how… more
- Conviva (Phoenix, AZ)
- …of our caring community and help us put health first** The Associate Director , Security Architecture will play a key role in implementing security architecture, ... ensure the enterprise can achieve the enterprise security strategy. The Associate Director , Security Architecture will play a key role in implementing security… more