- CVS Health (Hartford, CT)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Regulated Medicare Appeals: * Direct daily work on ... encumbrances * Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals… more
- Humana (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …make health care more personal, convenient and affordable. **Position Summary** As the Medicare Reporting Lead Director , you will be responsible for the ... of monthly, quarterly, and annual financial results for the Medicare segment. This role will allow you to own...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Hartford, CT)
- …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
- Humana (Hartford, CT)
- **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 (Hartford, CT)
- **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 (Hartford, CT)
- **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
- The Cigna Group (Bloomfield, CT)
- Job Title: Cigna Supplemental Benefits (CSB) Medical Director **Job Summary:** Cigna Supplemental Benefits (CSB) provides peace-of-mind and financial security ... for more than 800,000 policyholders of all ages through Medicare Supplement and Supplemental Health and Life (SHL) products....the lives of the individuals we serve. The CSB Medical Director will work closely with CSB's… more
- Evolent (Hartford, CT)
- …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
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director 's primary responsibility is the review of medical authorizations ... necessity of a given service, level of care, or medical item/supply. The Medical Director 's...experience + Knowledge of the managed care industry including Medicare or Medicaid products + Possess analysis and interpretation… more
- Evolent (Hartford, CT)
- …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
- South County Hospital (Wakefield, RI)
- South County Hospital is seeking a Medical Director for its Division of Hematology and Oncology. The Medical Director is responsible for the overall ... for all patients cared for within the Department. The Medical Director will work in partnership with...5-Star Overall Rating for Quality from the Centers for Medicare and Medicaid. In addition, we have 5 ambulatory… more
- Evolent (Hartford, CT)
- …$64M of savings for Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care / President of Evolent Care Partners and ... Medicare and Commercial contracts, including plans related to medical expense management, quality improvement, appropriate risk adjustment, and patient and… more
- Genesis Healthcare (Greenville, RI)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab SLP is responsible for the efficient management of… more
- Humana (Hartford, CT)
- …of our caring community and help us put health first** The Director , BH Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other ... provider contracts and agreements with behavioral health providers. The Director , BH Provider Contracting requires an in-depth understanding of how organization… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …of our caring community and help us put health first** The Director , IT Vendor Management establishes and implements hardware and software acquisition, protection, ... and procedures that are aligned with IT standards and strategy. The Director , IT Vendor Management requires an in-depth understanding of how organization… more
- Humana (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- **Position Summary:** The Senior Director is responsible for and contributes to the creation, execution, launch and management of the Specialty Drug Management ... and differentiators. In collaboration with Marketing and Sales Enablement, the Senior Director will lead the development of strong thought leadership strategies and… more
- CVS Health (Hartford, CT)
- …and affordable. **Position Summary** The Web Channel Owner role for Aetna Medicare is a critical position in our Marketing organization, with accountability for ... shepherd the delivery of Digital Marketing's capabilities backlog for Aetna.com/ Medicare , AllinaHealthAetnaMedicare.com, the Shop, Buy, and Enroll tool, and more,… more