- Humana (St. Paul, MN)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range ... of actuarial and business needs for specific product lines. The Director , Actuarial requires an...organization capabilities interrelate across the function or segment. The Director , Actuarial of Medicaid Pricing may be… more
- CVS Health (St. Paul, MN)
- … Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and ... Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and… more
- Prime Therapeutics (St. Paul, MN)
- …and Account Management Staff). + Serves as Preferred Drug List product lead for program implementation including developing relationships, RFP support, and other ... drives every decision we make. **Job Posting Title** Sr Director , Value Based Pricing - Preferably on the West...+ 10+ years' professional experience in managed care and/or Medicaid . + 5+ years' experience in account management… more
- HealthEdge Software Inc (St. Paul, MN)
- …(National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other State ... 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
- Humana (St. Paul, MN)
- …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 the technology ... transformation efforts focused on defining the product architecture standards and governance for API development across the enterprise. This role will bring together… more
- Prime Therapeutics (St. Paul, MN)
- …passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary** ... Medical Pharmacy Strategy. + Job Description + Supports overall Medical Pharmacy Product line for health plans through validated program enhancements, creation of… more
- The Cigna Group (Bloomington, MN)
- …competitive intel process leveraging transparency data as well as Medicare and Medicaid pricing. + Collaborate with Network Directors, Medical Directors, and ... product leadership to create new coverage policies for innovative...Center of Excellence Program along with with Network Medical Director and Clinical Operations which include but not limited… more
- Brookdale Senior Living (Minneapolis, MN)
- …Medicare and Medicaid regulations to include applicable processes for the product line(s) being sold. Knowledge of state regulations impacting or directing the ... you'll partner you will be partnering with community Executive Directors and District Director of Sales to improve occupancy and help many older adults live a… more