- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and ... quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as...President of Health Services, Lead, or Corporate Medical Director , depending on size of region… more
- CVS Health (Santa Fe, NM)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... home ) role and m** **ust have a California medical license and be willing to obtain an Arizona...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and ... 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 (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial. The… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization ... requests for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and ... quality management, utilization management, case management, discharge planning and/or home health or post acute services such...President of Health Services, Lead, or Corporate Medical Director , depending on size of region… more
- Cardinal Health (Santa Fe, NM)
- …that resides within the Cardinal Health Biopharma Solutions group within Cardinal Health . The Director , Sales & Business Development - Sonexus (TM) Access ... customer initiatives. This position will report to the Sales Director . This is a remote, work from home...a wide variety of benefits and programs to support health and well-being. + Medical , dental and… more
- Cardinal Health (Santa Fe, NM)
- …Cardinal Health Insights and Engagement, a division of Cardinal Health Specialty Solutions, delivers comprehensive consulting, medical marketing and ... Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing ... unstructured data to insights at enterprise scale. The Associate Director , Cloud Architecture requires an in-depth understanding of how...time that is best for your schedule. To ensure Home or Hybrid Home /Office employees' ability to… more
- Cardinal Health (Santa Fe, NM)
- …Cardinal Health offers a wide variety of benefits and programs to support health and well-being. Medical , dental and vision coverage Paid time off plan ... oncology practices to deliver patient-centered cancer care. Navista, a Cardinal Health company, is an oncology practice alliance co-created with oncologists and… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** Humana's Marketing organization is seeking a dynamic and experienced Director , Campaign ... increase speed to market and optimize campaign plans + Familiarity with the health insurance or pharmacy marketing sector is highly desirable + Prior Marketing… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** Associate Director , Enterprise API Standards and Governance is a pivotal role in leading ... + Prior management or team leadership experience **Additional Information** To ensure Home or Hybrid Home /Office employees' ability to work effectively, the… more
- Huron Consulting Group (Santa Fe, NM)
- …create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense ... of consulting and/or healthcare operations experience + One of the following, either home infusion experience or experience building a PBM. + Strong leadership and… more
- Evolent Health (Santa Fe, NM)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Evolent Health (Santa Fe, NM)
- …interpretation, guidelines and/or system support. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Evolent Health (Santa Fe, NM)
- …approach with call center staff. Initial clinical reviewers are supported by field medical director (MDs) in the utilization management determination process. + ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health … more
- Evolent Health (Santa Fe, NM)
- …required. + Entering data into a proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be submitted via ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...will serve as a point of contact for processing medical treatment requests in accordance with departmental policies, regulatory… more
- Cardinal Health (Santa Fe, NM)
- …Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off ... we are collectively the face and voice of WaveMark and Cardinal Health wherever WaveMark operates within the customer's organization. The WaveMark **Customer… more
- Evolent Health (Santa Fe, NM)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...Opportunities:** This person will also work closely with the Director of Client Finance to analyze and communicate client… more