- Catholic Health Initiatives (Lexington, KY)
- …the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market (s) development, implementation, evaluation and ... processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops... programs to meet the Care Coordination goals and market utilization management goals while… more
- Humana (Frankfort, KY)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Frankfort, KY)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Frankfort, KY)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... skills, with prior experience participating in teams focusing on quality management , utilization management , and acute inpatient rehabilitation… more
- Humana (Frankfort, KY)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- CVS Health (Frankfort, KY)
- …of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying ... members' physical, behavioral and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management leadership to… more
- J&J Family of Companies (Frankfort, KY)
- Associate Director , Thought Leader Liaison, Neurology Rare Disease - Southeast - 2406207031W **Description** Johnson & Johnson is recruiting for an Associate ... Director , Thought Leader Liaison, Neurology Rare Disease to support...ensure close working relationship with cross-functional partners in cross-functional market teams, in a compliant manner. This position will… more
- Norstella (Frankfort, KY)
- …in account management and/or leading client relationships. Mastered client management best practices & principles. + Market Access domain expertise ... Client Success Director Company: MMIT Location: Remote, United States Date...most complex challenges. MMIT is regarded as a trusted go-to- market partner that identifies barriers to patient access and… more
- SitusAMC (Frankfort, KY)
- …for all asset management personnel. + Oversee task allocation and staffing utilization for all client dedicated and pooled asset management personnel to ... is supervisory and has direct reports. This role is responsible for the overall management of multiple diverse asset management functions within Situs Asset … more
- Humana (Frankfort, KY)
- …least (5) five years of experience post-training providing clinical services + Experience in utilization management review and case management in a health ... community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral… more
- GovCIO (Frankfort, KY)
- **Overview** GovCIO is currently hiring for a Program Director to install and test new equipment and upgrades, installing, patching, and testing operating systems ... software, and monitoring HPC and research computing environment health and utilization . HPC and Linux systems design, engineering, administration and programming in… more
- Molina Healthcare (Georgetown, KY)
- …including, but not limited to, IT; Finance; Actuarial, Claims, Call Centers and Utilization and Care Management . Manages data analytic staff who assist in ... As a member of the Customer Experience team, the Director , Data Analytics ensures timely creation of key Executive...ensures timely creation of key Executive and Health plan management reports, as well as providing critical analytical insights.… more
- Cardinal Health (Frankfort, KY)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- PagerDuty (Frankfort, KY)
- …and sign-up for job alerts! PagerDuty is looking for an Strategic Software Sales Director who will lead a team of account executives to generate expansion business ... in any of the following: modern SaaS, enterprise or infrastructure management , application development and management , security, and/or analytics. **Your… more
- Prime Therapeutics (Frankfort, KY)
- …fuels our passion and drives every decision we make. **Job Posting Title** Sr. Director Actuarial Services - Remote **Job Description** The Senior Director of ... to provide strategic pricing advice on structures and methodology using market research, financial projections, and complex actuarial modeling + Collaborates with… more
- Prime Therapeutics (Frankfort, KY)
- …+ Creates effective rebate specific financial forecasts by monitoring pharmaceutical market and developing management strategy. + Manages relationships with ... drives every decision we make. **Job Posting Title** Sr Director , Value Based Pricing - Preferably on the West...conjunction with the Prime government division to guide account management and rebate contracting efforts for Preferred Drug List… more
- Prime Therapeutics (Frankfort, KY)
- …passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description Summary** ... client presentations + Leads evaluation and identification opportunities for improved management of Medical benefit drugs through clinical research and analytics… more
- Highmark Health (Frankfort, KY)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Verint Systems, Inc. (Frankfort, KY)
- …innovators with the passion, creativity, and drive to answer constantly shifting market challenges and deliver impactful results for our customers. Our commitment to ... enrollment processes, including obtaining and analyzing benchmark data and utilization data, identifying trends, preparing recommendations with impact assessments… more
- HealthEdge Software Inc (Frankfort, KY)
- …Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC ( Utilization Review Accreditation Commission) and other State regulatory bodies. The ideal ... support people need, when and where they need it. We call it Digital Health Management . Our comprehensive suite of Digital Health Management solutions for care … more