- HomeSafe Alliance (Annapolis, MD)
- …and motivated Assistant Claims Manager to assist in all aspects of claims management , to support and promote process improvement methodologies and best ... Raising awareness of any settlement practices, trends, or areas of concern to the Director of Claims . Responds to internal and external customer disputes and… 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)
- …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
- CVS Health (Annapolis, MD)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and appeal system. + Leads the administration of all medical management activities of the aligned Plans....the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Humana (Annapolis, MD)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director reviews cases of diverse scope and complexity ranging...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical /surgical utilization management review experience + Experience… 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
- Norstella (Annapolis, MD)
- …will be pivotal in integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health ... Senior Director , RWD Analytics and Innovation Company: Citeline Location:...of data and intelligence on clinical trials, drug treatments, medical devices and what's new in the regulatory and… more
- J&J Family of Companies (Annapolis, MD)
- Director , Health Economics and Market Access - Wound Closure and Healing and Biosurgery - 2406204292W **Description** Johnson & Johnson is recruiting a Director , ... and profoundly impact health for humanity. Learn more at https://www.jnj.com/. The Director , Health Economics & Market Access for the Wound Closure & Healing… more
- Cardinal Health (Annapolis, MD)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… 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
- Total Civil Construction & Engineering, LLC (Lanham, MD)
- Job Summary The Director of Human Resources is responsible for developing strategies to cost-effectively manage the human resources. Based upon market trends, ... on full-cycle staffing and retention, employee relations, training/development, Change Management , total rewards, and compliance Acts as primary liaison with… more
- Evolent Health (Annapolis, MD)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Norstella (Annapolis, MD)
- Director , RWD Product Company: MMIT Location: Remote, United States Date Posted: Jul 15, 2024 Employment Type: Full Time Job ID: R-440 **Description** Why Norstella? ... assess market potential, and inform strategic decision-making. + Translate product management strategy into actionable data deliverables, guiding development of data… more
- Evolent Health (Annapolis, MD)
- …LPCs, and Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Associate Director and Director ... 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
- Stantec (Laurel, MD)
- …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... Claims /Risk mitigation. + Oversee and approve development and management of the Project Scope WBS. + Oversee and...Internal (PGC) Monthly Reports; issue following review with Design Director . + Responsible for the formulation of the Project… more
- Johns Hopkins University (Lutherville, MD)
- …employee satisfaction. The individual reports to the Associate Administrator and Medical Director for Reproductive Endocrinology and Fertility. Will proactively ... and implement appropriate processes to ensure all facets of clinic practice management are effective. This may include scheduling efficiency, complete and accurate… more
- Teledyne (Hunt Valley, MD)
- …development, oceanographic research, deepwater oil and gas exploration and production, medical imaging and pharmaceutical research. We are looking for individuals ... relations issues, training, records maintenance, employee recognition programs, performance management and other various projects. Develop and implement activities… more
- The Cigna Group (Baltimore, MD)
- …rates. + Enhance the Facility Center of Excellence Program along with with Network Medical Director and Clinical Operations which include but not limited to ... experience required. + Experience in managed care operations and facility network management including behavioral and/or medical with experience with commercial… more
- Prime Therapeutics (Annapolis, MD)
- …experience conducting complex analysis on enterprise level data sets of pharmacy, claims , medical , and/or financial data + Extensive experience with analytic ... to create new business insights related to total cost management , products and services and drives recommendations for improvements...to adjust focus **Reporting Structure** + Reports to Manager, Director or Senior Director in the Consulting… more