• Medicare Grievances and Appeals Corporate…

    Humana (Concord, NH)
    …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
    Humana (01/07/25)
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  • Manager, FP&A, Medicare /Medicaid of IL

    CVS Health (Concord, NH)
    …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
    CVS Health (01/17/25)
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  • Medical Director - Mid West Region

    Humana (Concord, NH)
    **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 (10/29/24)
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  • Medical Director - Gulf South

    Humana (Concord, NH)
    **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 (12/03/24)
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  • Medical Director --Claims Management

    Humana (Concord, NH)
    **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 (10/29/24)
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  • Field Medical Director , Cardiology

    Evolent (Concord, NH)
    …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 (11/15/24)
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  • Field Medical Director , Radiology…

    Evolent (Concord, NH)
    …Evolent 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
    Evolent (12/09/24)
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  • Managing Director , Value Based Care…

    Evolent (Concord, NH)
    …$64M of savings for Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care / President of Evolent Care Partners and ... Medicare and Commercial contracts, including plans related to medical expense management, quality improvement, appropriate risk adjustment, and patient and… more
    Evolent (01/22/25)
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  • Associate Director , Actuarial

    Humana (Concord, NH)
    …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
    Humana (12/12/24)
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  • Regional Account Director

    Takeda Pharmaceuticals (Concord, NH)
    …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
    Takeda Pharmaceuticals (01/16/25)
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  • Associate Director Cloud Architecture

    Humana (Concord, NH)
    …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
    Humana (11/02/24)
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  • Director of Oncology

    HCA Healthcare (Derry, NH)
    …is incentive eligible. **Introduction** Do you have the career opportunities as a Director of Oncology you want with your current employer? We have an exciting ... opportunity for you to join Parkland Medical Center which is part of the nation's leading...of colleagues. Do you want to work as a(an) Director of Oncology where your passion for creating positive… more
    HCA Healthcare (11/05/24)
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  • Associate Analytics, Insights & Operations…

    United Therapeutics (Concord, NH)
    …orphan diseases. **How you'll contribute** The Associate Analytics, Insights and Operations Director , Market Access will lead data support across all functions of ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… more
    United Therapeutics (01/23/25)
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  • Director , Insurance Strategy

    Humana (Concord, NH)
    …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
    Humana (12/21/24)
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  • Director , Formulary Strategy Development

    Elevance Health (Manchester, NH)
    …care. CarelonRx's Pharmaceutical Rebates Org is looking to hire a ** Director , Formulary Strategy Development.** This high-performing individual contributor will play ... in driving affordability across multiple lines of business (Commercial, Medicaid, Medicare , ASO clients) by partnering with internal and external stakeholders to… more
    Elevance Health (01/22/25)
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  • Provider Network Management Director

    Elevance Health (Manchester, NH)
    Provider Network Management Director (JR136035) **Location** **:** Must reside in New Hampshire or outlying state and requires residence within 50 miles and 1 hour ... office. Monday and Tuesdays preferred. The **Provider Network Management Director ** develops the provider network through contract negotiations, relationship… more
    Elevance Health (01/14/25)
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  • RN Manager Behavioral Health

    HCA Healthcare (Rochester, NH)
    …care and services to external review and regulatory agencies. Consults with GPU medical providers, Program Director and social workers to assess psychosocial ... stay when appropriate and to optimize resource consumption. Collaborates with Program Director , medical providers, patient accounts, and other related parties on… more
    HCA Healthcare (12/18/24)
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  • Therapist-PT PB Rehab to You

    Genesis Healthcare (Dover, NH)
    …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 ... in collaboration with licensed therapists, the Clinical Operations Area Director , and Clinical Director . Coordinates Powerback Rehabilitation personnel… more
    Genesis Healthcare (01/10/25)
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  • Complex Care Program Delivery Operations Lead

    CenterWell (Concord, NH)
    …Operations Lead** **Job Summary** The Program Delivery Lead will partner with the National Director of Program Delivery to design, communicate, and implement ... regarding implementation, planning, and execution of programs and advises the Director of Program Delivery and significant functional strategies. The Program… more
    CenterWell (01/18/25)
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  • Principal Client Solution Architect - State…

    Mathematica (Concord, NH)
    …and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through ... methodology. * Conceptual and practical knowledge of health data (eg commercial, Medicare , Medicaid, or APCD claims data; EHR and/or HIE data; healthcare… more
    Mathematica (01/04/25)
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