• Medicare Medical Director

    Elevance Health (Manchester, NH)
    ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (01/08/25)
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  • Medical Director - National…

    Humana (Concord, NH)
    …analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides ... caring community and help us put health first** The Medical Director relies on medical ...or Surgery specialties + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (11/08/24)
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  • Medicare Grievances and Appeals Corporate…

    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
    Humana (01/07/25)
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  • Medical Director - Mid West Region

    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 (10/29/24)
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  • Medical Director --Claims Management

    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
    Humana (10/29/24)
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  • Medical Director - Florida

    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 (12/14/24)
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  • Field Medical Director , Cardiology

    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. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (11/15/24)
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  • Field Medical Director -ENT

    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. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (12/09/24)
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  • Associate Director , Actuarial

    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
    Humana (12/12/24)
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  • Regional Account Director

    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
    Takeda Pharmaceuticals (01/16/25)
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  • Director Healthcare Economics & Trend…

    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
    Baylor Scott & White Health (12/21/24)
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  • Associate Director Cloud Architecture

    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
    Humana (11/02/24)
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  • Director of Oncology

    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
    HCA Healthcare (11/05/24)
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  • Director , Medicaid Trend Mitigation…

    Humana (Concord, NH)
    …part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and ... planning support for business segments or the company at large. The Director , Medicaid Trend Mitigation Strategy requires an in-depth understanding of how… more
    Humana (01/08/25)
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  • Director , Insurance Strategy

    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
    Humana (12/21/24)
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  • Provider Network Management Director

    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
    Elevance Health (01/14/25)
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  • Insurance Strategy Consultant

    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
    Humana (11/05/24)
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  • Principal Client Solution Architect - State…

    Mathematica (Concord, NH)
    …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)
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  • Chief Clinical Officer

    Evolent (Concord, NH)
    … 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)
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  • Program Assistant, Rehab - Full time - Days

    Covenant Health (Nashua, NH)
    …the telephone triage of all calls forwarded to the rehabilitation center. Assists Medical Director with authorizations for Botox. Responsible for accurate & ... experience as it relates to the position. Summary Under the supervision of the Program Director , the Program Assistant has the responsibility and accountability for… more
    Covenant Health (12/25/24)
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