• Medical Director - Medicare

    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 (03/13/25)
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  • Medical Director - National…

    Humana (Annapolis, MD)
    …analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (03/11/25)
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  • Medicare Benefits Standards & Guidance Lead…

    CVS Health (Annapolis, MD)
    … Medicaid Services) requires regulatory changes during the plan year. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** ensures accountability for ... Individual general enrollment, Special Needs Plans (SNP) and Employer Groups. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** acts as the… more
    CVS Health (03/14/25)
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  • Medical Director - Care Plus

    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 (03/06/25)
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  • Physician Medical Director - LTSS

    Humana (Annapolis, MD)
    …community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical ... necessity of a given service, level of care, or medical item/supply. The Medical Director 's...experience + Knowledge of the managed care industry including Medicare or Medicaid products + Possess analysis and interpretation… more
    Humana (01/25/25)
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  • Medical Director - Medicaid N.…

    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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (03/11/25)
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  • Field Medical Director , Cardiology

    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. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (02/14/25)
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  • Field Medical Director

    Evolent (Annapolis, MD)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (01/30/25)
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  • Behavioral Health Medical Director

    Humana (Annapolis, MD)
    …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
    Humana (02/15/25)
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  • Field Medical Director , Genetic…

    Evolent (Annapolis, MD)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (02/18/25)
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  • Senior Director , Public Policy

    Otsuka America Pharmaceutical Inc. (Washington, DC)
    …to the Vice President of Government Affairs & Public Policy, the Sr. Director of Public Policy is responsible for directing, developing, and executing the enterprise ... policy agenda enabling and driving Otsuka's priorities. The Sr. Director will lead a public policy team of two...leaders, engages in strategic business planning, provides input to medical , clinical and regulatory priorities to meet the needs… more
    Otsuka America Pharmaceutical Inc. (02/05/25)
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  • Associate Medical Director

    Evolent (Annapolis, MD)
    …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play...or disciplinary actions by **state or federal healthcare programs ( Medicare , Medicaid, OIG, or GSA).** Join us at **Evolent… more
    Evolent (03/04/25)
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  • Director -Rehab OT

    Genesis Healthcare (Mitchellville, 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 ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab OT is responsible for the efficient management of… more
    Genesis Healthcare (01/21/25)
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  • Associate Director - Value-Based Specialty…

    Humana (Annapolis, MD)
    …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
    Humana (03/04/25)
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  • Executive Director , Compliance

    NASCO (Annapolis, MD)
    **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the company's ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
    NASCO (02/11/25)
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  • Director , Home Healthcare

    BAYADA Home Health Care (Glen Burnie, MD)
    …excellence, and reliability** to our clients and their families. As a **Home Health Director ** in **Glen Burnie, MD** , you'll have the chance to **lead, innovate, ... **What Your Day Looks Like as a Home Health Director ** + **Lead and inspire** a team of compassionate...sources, and community partners to expand and grow our Medicare Certified Home Health Office. + **Drive operational success**… more
    BAYADA Home Health Care (03/13/25)
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  • Director of Clinical Operations/ RN - Home…

    BrightSpring Health Services (Upper Marlboro, MD)
    …+ Ensure compliance with regulatory standards. Our comprehensive benefits include: + Medical , dental and vision + Short and long-term disability + Mileage ... managing clinical teams and planning + In the absence of the Executive Director /Administrator, the Director , Clinical Operations will become the acting Executive… more
    BrightSpring Health Services (03/06/25)
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  • Director , Competitive Intelligence, Stars

    Humana (Annapolis, MD)
    …will join the Health Quality and Stars (HQS) leadership team as the Director , Competitive Intelligence to drive the strategic vision of the company's Stars ... Ratings. The ideal candidate will possess a deep understanding of the Medicare landscape, strong analytical skills and the ability to communicate insights… more
    Humana (03/04/25)
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  • Assistant Director of Nursing

    Sunrise Senior Living (Arlington, VA)
    …big breath of fresh air."_** **_- Sunrise Leader_** At Sunrise, our Assistant Director of Nursing Services is responsible for providing assistance and supervision of ... consistent delivery of quality resident services - Assisting the Director of Nursing Services (DNS) in maintaining the skilled...budget to include but not limited to labor expense, medical supplies, census - Understands and assists with the… more
    Sunrise Senior Living (02/12/25)
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  • Risk Adjustment Compliance Director

    Humana (Annapolis, MD)
    …community and help us put health first** The Risk Adjustment Compliance Director ensures compliance with governmental requirements. The Risk Adjustment Compliance ... Director requires an in-depth understanding of how organization capabilities...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (03/11/25)
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