• Medicare Grievances and Appeals Corporate…

    Humana (Washington, DC)
    …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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  • Medical Director - Mid West Region

    Humana (Washington, DC)
    **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 - Florida

    Humana (Washington, DC)
    **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 (12/14/24)
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  • Medical Director --Claims Management

    Humana (Washington, DC)
    **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 (Washington, DC)
    …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 -ENT

    Evolent (Washington, DC)
    …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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  • Medical Director - Commercial…

    CVS Health (Washington, DC)
    …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
    CVS Health (11/13/24)
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  • Director - Rehab Asst PTA

    Genesis Healthcare (Reston, VA)
    …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 ... Clinicians in Action professional development program. Responsibilities The Assistant Director of Rehab is responsible for assisting the ...period of one year. 5. A thorough knowledge of Medicare and third party billing is also required. 6.… more
    Genesis Healthcare (01/10/25)
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  • Associate Director , Actuarial

    Humana (Washington, DC)
    …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 (Washington, DC)
    …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 (Washington, DC)
    …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 -Asst Rehab Clinical

    Genesis Healthcare (Waldorf, MD)
    …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 ... with our Clinicians in Action professional development program. Responsibilities The Assistant Director of Rehab (or In-Training Director of Rehab) is… more
    Genesis Healthcare (01/10/25)
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  • Policy & Reimbursement, Senior Director

    GRAIL (Washington, DC)
    …focusing on maximizing the impact through strategic interactions with the Centers for Medicare and Medicaid Services (CMS) and the CMS Coverage and Analysis Group ... Administrator, the Center for Clinical Standards and Quality (including the Chief Medical Officer and the vitally important Center for Coverage and Analysis), and… more
    GRAIL (12/07/24)
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  • Director , Insurance Strategy

    Humana (Washington, DC)
    …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 - Public Affairs - Policy - Tax…

    Novo Nordisk (Washington, DC)
    …potential? This role can sit in Plainsboro, NJ or Washington, DC. The Position The Director - US Tax, Trade, IP works on complex issues that will require an in-depth ... globally. Relationships Reports to the Market Access and Public Affairs Senior Director , Policy. Other internal relationships include a dotted line with Corporate… more
    Novo Nordisk (11/19/24)
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  • Director , Federal Affairs

    Humana (Washington, DC)
    …caring community and help us put health first** Humana is seeking a Director of Government Federal Affairs to join our growing government Federal affairs department, ... Affairs. **Location:** Washington, DC **-** hybrid in office The role of Director , Federal Government Affairs involves direct engagement with Senate, House, and/or… more
    Humana (01/16/25)
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  • Regional Director of Clinical Operations-…

    Trinity Health (Silver Spring, MD)
    **Employment Type:** Full time **Shift:** **Description:** **Regional Director of Clinical Operations** **Location:** Silver Spring, MD **About the Role** The ... **Regional Director of Clinical Operations** provides leadership and strategic direction...operations. + Knowledge of state and federal regulations and Medicare Conditions of Participation. + Experience with Joint Commission… more
    Trinity Health (01/10/25)
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  • Director -Rehab Clinical

    Genesis Healthcare (Silver Spring, MD)
    …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 ... Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of...in the state of practice 3. Thorough knowledge of Medicare and third party billing required 4. Must have… more
    Genesis Healthcare (01/10/25)
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  • Healthcare Value-Based Care Leader (associate…

    Guidehouse (Mclean, VA)
    …client relationships, and delivering impactful project results within the Centers for Medicare & Medicaid Services (CMS). You will own the delivery of projects ... reflects our commitment to creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance + Personal and Family Sick Time &… more
    Guidehouse (12/01/24)
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  • Insurance Strategy Consultant

    Humana (Washington, DC)
    …organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises ... experience leveraging core consulting skills to support delivering some of Medicare and Medicaid's highest priority projects and initiatives, with an emphasis… more
    Humana (11/05/24)
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