• Medical Director -- Claims

    Humana (Richmond, VA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/29/24)
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  • Medical Director - Gulf South

    Humana (Richmond, VA)
    …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 (12/03/24)
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  • Director , HIV Medical Affairs - NYC…

    Merck (Richmond, VA)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
    Merck (12/19/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Richmond, VA)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (01/07/25)
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  • Director Network Management

    Elevance Health (Richmond, VA)
    ** Director Network Management - Carelon Behavioral Health** Location: Alternate locations may be considered. This position will work a hybrid model (remote and ... RVP of Provider Networks in the East for Carelon Behavioral Health, this ** Director of Network Management ** oversees the recruitment and negotiation of providers… more
    Elevance Health (01/22/25)
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  • Risk Director

    Robert Half Management Resources (Richmond, VA)
    …on managing property and casualty insurance programs, contractual risk transfer, and claims management . Responsibilities: * Oversee the day-to-day operations of ... offering a contract to permanent employment opportunity for a Director of Rick role! Your role will encompass the...oversee the organization's grant-funded workers compensation program * Oversee claims management , ensuring that all claims more
    Robert Half Management Resources (01/17/25)
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  • Oncology Regional Medical Scientific…

    Merck (Richmond, VA)
    …needs to support collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, ... **Job Description** Our Medical Affairs team advances patient care by engaging...and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
    Merck (01/10/25)
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  • Director , US Benefits

    Cardinal Health (Richmond, VA)
    …and delivers human resource programs and policies, including recruitment, talent management , diversity and inclusion, compensation and benefits, among others. This ... **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the...Benefits to lead and oversee the design, implementation, and management of employee benefit programs. This role will be… more
    Cardinal Health (01/11/25)
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  • Associate Analytics, Insights & Operations…

    United Therapeutics (Richmond, VA)
    …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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  • Associate Director Data Science, US…

    Merck (Richmond, VA)
    …deliver measurable impact in commercial pharma landscape. + Knowledge in mining medical claims /EMR, social media, etc. data with a strategic/inquisitive mindset ... **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater… more
    Merck (01/14/25)
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  • Director , Global Labeling Strategy Lead

    Takeda Pharmaceuticals (Richmond, VA)
    …plasma-derived therapies for patients with immunologic, hematologic, and other complex diseases. The Director , Global Labeling Strategy Lead is a key role in the PDT ... new TLP, CCDS, USPI and EU SmPC. **How you will contribute:** ** Management of Labeling Cross-Functional Teams** + Leads Labeling cross-functional teams providing… more
    Takeda Pharmaceuticals (01/26/25)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Richmond, VA)
    …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
    Takeda Pharmaceuticals (01/15/25)
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  • AVP, Medical Bill Review Litigation

    Zurich NA (Richmond, VA)
    …Member of the Bar + Extensive experience in and in-depth knowledge of Casualty claims management + Highly detail-oriented with a strong focus on accuracy + ... AVP, Medical Bill Review Litigation 119916 Zurich Insurance is...and other legal filings + Maintain accurate and up-to-date claims documentation, ensuring compliance with best practices for high-complexity… more
    Zurich NA (01/22/25)
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  • Principal Client Solution Architect - State…

    Mathematica (Richmond, VA)
    …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and… more
    Mathematica (01/04/25)
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