• Medicare Grievances and Appeals Corporate…

    Humana (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Manager, FP&A, Medicare /Medicaid of IL

    CVS Health (Jefferson City, MO)
    …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
    CVS Health (01/17/25)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Mid West Region

    Humana (Jefferson City, MO)
    **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)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Gulf South

    Humana (Jefferson City, MO)
    **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 (12/03/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director --Claims Management

    Humana (Jefferson City, MO)
    **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)
    - Save Job - Related Jobs - Block Source
  • Field Medical Director , Cardiology

    Evolent (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Field Medical Director -General…

    Evolent (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Associate Director , Actuarial

    Humana (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Regional Account Director

    Takeda Pharmaceuticals (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Associate Director Cloud Architecture

    Humana (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Director , Insurance Strategy

    Humana (Jefferson City, MO)
    …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)
    - Save Job - Related Jobs - Block Source
  • Complex Care Program Delivery Operations Lead

    CenterWell (Jefferson City, MO)
    …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
    CenterWell (01/18/25)
    - Save Job - Related Jobs - Block Source
  • Principal Client Solution Architect - State…

    Mathematica (Jefferson City, MO)
    …and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through ... methodology. * Conceptual and practical knowledge of health data (eg commercial, Medicare , Medicaid, or APCD claims data; EHR and/or HIE data; healthcare… more
    Mathematica (01/04/25)
    - Save Job - Related Jobs - Block Source
  • Chief Clinical Officer

    Evolent (Jefferson City, MO)
    … Officer. The CCO will lead the Clinical Operations team and work with medical director leadership to ensure consistent and efficient adjudication of clinical ... Services team, the CCO will also have dotted line oversight over field medical director (FMD) operational responsibilities, provide strategic input into … more
    Evolent (12/21/24)
    - Save Job - Related Jobs - Block Source
  • Certified Occupational Therapy Assistant COTA Home…

    Elara Caring (Jefferson City, MO)
    medical conditions), race, color, age (40 and older), national origin, religion, disability, genetic information, marital status, sexual orientation, gender ... and continuing education opportunities for all employees + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer match + Paid… more
    Elara Caring (01/03/25)
    - Save Job - Related Jobs - Block Source