- 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 ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Phoenix, AZ)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- 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 ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...Board Certified in ABMS Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance &… 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 reviews cases of diverse scope...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… 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
- CVS Health (Phoenix, AZ)
- …**Position Summary** CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… 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
- CenterWell (Phoenix, AZ)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic...and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare … more
- Boehringer Ingelheim (Phoenix, AZ)
- …expectations for insight generation related to scientific objectives. + In collaboration with Medical Excellence, the MSL Director and TA Sr. AD MSLs, identify ... programs reflect Boehringer Ingelheim's high regard for our employees. The Sr. AD, Medical Science Liaison will manage a regional therapeutic area specific MSL team.… more
- CenterWell (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety of medical ... and medical codes (eg, ICD-10-CM, CPT) to patient records. The Director , Medical Coding requires an in-depth understanding of how organization capabilities… more
- Banner Health (Phoenix, AZ)
- …a strong knowledge and understanding of managed care operations, reimbursement models, medical protocols and criteria including Medicare criteria, and peer ... Services Organization (PHSO), will serve as the clinical DYAD to the Executive Director of Risk Adjustment, co-leading a robust team that will support the plan… more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Prime Therapeutics (Phoenix, AZ)
- …legislative/oversight bodies (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA- National Committee for ... passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary**… more
- Cardinal Health (Phoenix, AZ)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Humana (Phoenix, AZ)
- …providing frameworks to maximize available resources to achieve growth. The ** Director ,** **Medicaid Insurance Product Management and Wellness Strategy** will have ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on building a ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** Associate Director , Enterprise API Standards and Governance is a pivotal role in leading the technology ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Wells Fargo (Scottsdale, AZ)
- **About this role:** Wells Fargo is seeking an Executive Director of Retirement Planning and Financial Goals with demonstrated experience in retirement savings ... and Best Interests rules, retirement planning, income strategies, Social Security, Medicare , insurance and other risk management strategies, and financial planning… more
- HealthEdge Software Inc (Phoenix, AZ)
- …NCQA ( National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other ... to solve critical needs in healthcare. This individual will report to the Chief Medical Officer of Healthedge (HE) and ensure that our clinical suite of products… more