- Humana (Salt Lake City, UT)
- **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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Salt Lake City, UT)
- …put health first** Humana's Marketing organization is seeking an Associate Director , Product Marketing to lead the go-to-market, positioning, and member-focused ... campaigns for our Medicaid lines of business. You will craft the product...on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Evolent (Salt Lake City, UT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Salt Lake City, UT)
- **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 (Salt Lake City, UT)
- **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 (Salt Lake City, UT)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Salt Lake City, UT)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Salt Lake City, UT)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Salt Lake City, UT)
- …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...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- Humana (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- Humana (Salt Lake City, UT)
- …our caring community and help us put health first** The Associate Director , Technology Solution Implementation delivers new technological solutions to meet business ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Humana (Salt Lake City, UT)
- …of our caring community and help us put health first** The Associate Director of Cloud Infrastructure Operations is responsible for leading Humana's enterprise cloud ... at the intersection of operations, technology, and AI innovation. The Associate Director of Cloud Infrastructure Operations will drive the evolution of Humana's… more
- Humana (Salt Lake City, UT)
- …part of our caring community and help us put health first** The Associate Director of IT Disaster Recovery will lead DR operations and governance for all application ... PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Sumitomo Pharma (Salt Lake City, UT)
- …a dynamic, highly motivated, and experienced individual for the position of Associate Director , Market Access Engagement - Rare Disease, who will act as the face ... various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove reimbursement barriers to treatment + Build and maintain strong… more
- Cognizant (Salt Lake City, UT)
- …+ Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... **Schedule:** Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work… more
- Molina Healthcare (Layton, UT)
- …Tighter knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates Complex Provider contracts including but not ... and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract… more
- Danaher Corporation (Salt Lake City, UT)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE ) position is a provider / customer facing role responsible for ... to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the...Value and Access team. This position will be a remote position ideally located in the western part of… more
- Public Consulting Group (Salt Lake City, UT)
- …issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist with other ... errors and denied claim research results, final remittance advice processing, and medical record reviews that will include discussion with internal management to… more
- Humana (Salt Lake City, UT)
- …and other skills IT Associates needs to succeed. + Partners with Associate Director to develop, refine, and prioritize the skilling roadmap, aligning future skills ... allows, the rest of IT. + Supports the Associate Director in all reporting (eg, and type of learning...PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Humana (Salt Lake City, UT)
- …Leader - AEP Readiness & Automation **Location:** Louisville, KY / Remote **Department:** Technology Solutions **Reports To:** Director , Technology Solutions ... ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote Travel: While this is a remote ...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more