- Humana (St. Paul, MN)
- **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
- Evolent (St. Paul, MN)
- …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
- Option Care Health (St. Paul, MN)
- …and brightest talent in healthcare. **Job Description Summary:** The Specialty Sales Director will develop and implement the Specialty business sales plan that ... geographic area of responsibility. It will be imperative for the Specialty Sales Director to work closely with the other Sales Directors and the Vice Presidents… more
- Humana (St. Paul, MN)
- **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 (St. Paul, MN)
- **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 (St. Paul, MN)
- …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 (St. Paul, MN)
- …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 (St. Paul, MN)
- …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 (St. Paul, MN)
- **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 (St. Paul, MN)
- …initiatives across Pharmacy, Primary Care, Home Solutions, the Office of the Chief Medical Officer, and Integrated Health. The Director and team will provide ... caring community and help us put health first** The Director , IT Portfolio Management collaborates with the business portfolio.../ HIPAA information. + Work-at-home location is flexible and remote within the US. Preference will be given to… more
- Humana (St. Paul, MN)
- …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 (St. Paul, MN)
- …part of our caring community and help us put health first** The Director , Product Management for CenterWell Pharmacy Digital leads the strategic vision, development, ... business objectives, including accelerating growth in payor agnostic markets. Additionally, the Director will lead a team of Product Owners (POs) and Product… more
- Humana (St. Paul, MN)
- …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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | Eagan, ... join us. The Impact You Will Have The Senior Director of Health Services, Utilization Management is responsible for...and maximize value. * Works with Commercial, Medicare, and Medicaid leadership to ensure programs and products meet the… more
- Humana (St. Paul, MN)
- …a part of our caring community and help us put health first** The Director of Finance Portfolio Management, Strategy, & Special Projects is a key leadership role ... focused on continuously improving consumer experiences Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may… more
- Humana (St. Paul, MN)
- …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
- Guidehouse (Bloomington, MN)
- … medical billing and auditing experience + Associate's degree\#IndeedSponsored\#LI- Remote #LI-DNI The annual salary range for this position is ... None **Clearance Required** **:** None This position is fully remote **What You Will Do** **:** + Under the...Will Do** **:** + Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing… more
- Adecco US, Inc. (Minneapolis, MN)
- …Proactively manages and identifies potential barriers for members + Collaborates with the medical director on complex cases to ensure members receive appropriate ... Life Sciences** is working with our client to hire REMOTE Care Advocates. Associates can reside anywhere; HOWEVER you...provider to offer a peer-to-peer consultation with the RMHP medical director , allowing the provider to present… more
- Public Consulting Group (St. Paul, MN)
- …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 (St. Paul, MN)
- …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