- Humana (Nashville, TN)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Nashville, TN)
- …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 reviews cases of diverse scope...rendered by healthcare professionals in compliance with CMS guidelines, clinical coverage criteria, and quality standards. Represents Humana at… more
- CenterWell (Nashville, TN)
- …part of our caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic pharmacy leader responsible for developing, ... Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: +...(SME) and clinical liaison to the national clinical leadership (including Chief Medical Officer, Complex… more
- The Cigna Group (Nashville, TN)
- …Operations Senior Advisor will report to the Stars and Risk Adjustment Managing Director and will be responsible for internal and external team communications and ... the other lines of businesses, stakeholders, and matrix partners (ex. Clinical , Compliance, Operations, Growth, Finance, etc.), providing proactive identification of… more
- Vanderbilt University Medical Center (Nashville, TN)
- …preeminent programs in patient care, education, and research. **Organization:** VICC - Clinical Trials 40 **Job Summary:** The Assistant Director supervises a ... **Discover Vanderbilt University Medical Center:** Located in Nashville, Tennessee, and operating...eg, hiring, promotion and termination. Required Qualifications: * Direct Clinical trial budgeting experience * Oncology experience * Understanding… more
- Prime Therapeutics (Nashville, TN)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description ... Medical Pharmacy clients and potential new clients. Required to serve as a Medical Pharmacy clinical resource throughout the organization and support all … more
- Humana (Nashville, TN)
- **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 (Nashville, TN)
- … Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Nashville, TN)
- **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 (Nashville, TN)
- …community and help us put health first** Humana Healthy Horizons is seeking a Medical Director to provide medical interpretations and determinations on ... colleagues and the Regional VP of Health Services. The Medical Director reports to the Lead ...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Elevance Health (Nashville, TN)
- …reviews within our Medicaid and Medicare programs.** The **Behavioral Health Medical Director ** is responsible for the administration of behavioral health ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...an entire clinical program and/or independently performs clinical reviews. + The Medical Director… more
- Humana (Nashville, TN)
- …& Supports or LTC/SNF with 5+ years of experience preferred **Additional Information** The Medical Director conducts clinical reviews of the care received by ... caring community and help us put health first** The Medical Director 's primary responsibility is the review...an in-depth evaluation of variable factors that rely on clinical experience and knowledge of both medicine and social… more
- CenterWell (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety of ... and medical codes (eg, ICD-10-CM, CPT) to patient records. The Director , Medical Coding requires an in-depth understanding of how organization capabilities… more
- HCA Healthcare (Nashville, TN)
- …chief nursing officers (CNO) and other hospital/ASC, board of trustee and medical staff leaders regarding clinical performance improvement and foundational ... join an organization that invests in you as a(an) Director Regulatory and Accreditation? At Work from Home, you...and presents educational programs for HCA Healthcare hospital/ASC and medical staff leaders regarding requirements of clinical … more
- HCA Healthcare (Nashville, TN)
- …officers, chief nursing officers, and other hospital/ASC board of trustee and medical staff leaders regarding clinical performance improvement and foundational ... an organization that invests in you as a Senior Director Regulatory and Accreditation? At HCA Healthcare, you come...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Green Hills Center for Rehabilitation and Healing (Nashville, TN)
- …computerized systems to optimize data quality and maximize therapist efficiency. Managing Medicare Medical Review and Denials Management process in conjunction ... and maintaining an effective rapport with the facility administrator and medical director . Demonstrating superior customer service through courtesy, consistent… more
- Humana (Nashville, TN)
- …They will lead and guide others in providing integrated services for the clinical teams. The Associate Director , Care Management requires a solid understanding ... health first** Humana Healthy Horizons in Virginia is seeking an Associate Director , Care Management (LTSS/ABD) who will lead teams of healthcare professionals… more
- Prime Therapeutics (Nashville, TN)
- …and drives every decision we make. **Job Posting Title** Trade Client Strategy Director - Remote **Job Description** The Trade Client Relations Director is ... responsible for the analysis, modeling and delivery of innovative pharmacy and medical rebate strategies and cost saving solutions to Prime's clients to ensure Prime… more
- Cardinal Health (Nashville, TN)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Brookdale Senior Living (Brentwood, TN)
- …would involve partnering with various districts when there are vacancies in our District Director of Sales position. We require 3-5 years of proven track record of ... on a scheduled basis and as approved by Divisional Director of Sales or VP of Sales. Partners with...to achieve and maintain full occupancy. + Interacts with Clinical Operations and other corporate support associates. Educates and… more