- Humana (Concord, NH)
- …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
- CVS Health (Concord, NH)
- …and affordable. **Position Summary** As the Manager, FP&A, you will report directly to Director of Finance and will monitor the end to end profit & loss statements, ... data submission for the purpose of rate setting and medical trend analysis on behalf of the Health Plan....nature of this remote role, candidates must have some Medicare and/or Medicaid experience. **Required Qualifications** -5 or more… more
- Humana (Concord, NH)
- **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 (Concord, NH)
- **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 (Concord, NH)
- **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
- Evolent (Concord, NH)
- …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 (Concord, NH)
- …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
- Dartmouth Health (Keene, NH)
- Overview Associate Medical Director - Cheshire Hospital Medicine Physician Advisor The Cheshire Medical Center’s Department of Hospital Medicine is a ... second-level medical necessity reviews, educating physicians on medical necessity for inpatient/outpatient services, reviewing Medicare Condition… more
- Tufts Medicine (Lawrence, MA)
- **Tufts Medicine Care at Home** is currently seeking an **Associate Medical Director ** to join our **hospice** team in the greater **Lowell** area. This position ... or life-limiting illness. **How You'll Transform Patient Care:** + Provide direct medical care, disease management, pain and symptom management of hospice patients.… more
- Humana (Concord, NH)
- …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
- Takeda Pharmaceuticals (Concord, NH)
- …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
- Humana (Concord, NH)
- …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
- Baylor Scott & White Health (Concord, NH)
- …adjudicated claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and ... Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support...Baylor Scott & White Quality Alliance Commercial, DTE, and Medicare (MSSP ACO, Medicare Advantage) lines of… more
- HCA Healthcare (Derry, NH)
- …is incentive eligible. **Introduction** Do you have the career opportunities as a Director of Oncology you want with your current employer? We have an exciting ... opportunity for you to join Parkland Medical Center which is part of the nation's leading...of colleagues. Do you want to work as a(an) Director of Oncology where your passion for creating positive… more
- Humana (Concord, NH)
- …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
- Elevance Health (Manchester, NH)
- Provider Network Management Director (JR136035) **Location** **:** Must reside in New Hampshire or outlying state and requires residence within 50 miles and 1 hour ... office. Monday and Tuesdays preferred. The **Provider Network Management Director ** develops the provider network through contract negotiations, relationship… more
- Tufts Medicine (Lowell, MA)
- …hospice fees, costs and reimbursement sources. Escalates to referral management director and/or referral manager, in circumstances of potential admission where ... indicatean appropriate hospice referral. Presents the advantage of the hospice Medicare /Medicaid benefits to referral sources. + Thoroughly understands the … more
- Humana (Concord, NH)
- …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
- Advocates (Waltham, MA)
- …other members of the multidisciplinary teams, including students, if assigned. + Work with Medical Director and Clinical Program Director to develop and ... if the candidate demonstrates to the satisfaction of the Medical Director comparable experience and competence). +...a minimum of $1,000,000/$3,000,000. + Satisfactory report from the National Practitioner Data Bank and absence of Medicare… more
- CenterWell (Concord, NH)
- …Operations Lead** **Job Summary** The Program Delivery Lead will partner with the National Director of Program Delivery to design, communicate, and implement ... regarding implementation, planning, and execution of programs and advises the Director of Program Delivery and significant functional strategies. The Program… more