- Ryder System (Pierre, SD)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
- Humana (Pierre, SD)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Pierre, SD)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Pierre, SD)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Humana (Pierre, SD)
- …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...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Merck (Pierre, SD)
- **Job Description** The Regional Medical Scientific Director (RMSD) is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages in ... scientific exchange with leaders in the external medical and scientific community. RMSDs provide to Scientific Leaders...areas of interest _*Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
- Merck (Pierre, SD)
- **Job Description** The Hematology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic and disease expert who ... engages in scientific exchange with leaders in the external medical and scientific community. Scientific exchange does not include promotional claims about any… more
- Pfizer (Pierre, SD)
- …opportunities for improving patient care, closing quality gaps, and addressing population health management . + Serve as the Field Medical Outcomes lead for ... field-based medical /outcomes role. + Experience analyzing health care data ( claims , electronic health records, other health care data). + Expertise in Clinical… more
- Prime Therapeutics (Pierre, SD)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
- Trustmark (Pierre, SD)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
- CVS Health (Pierre, SD)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...+ May assist in the research and resolution of claims payment issues + Supports the administration of the… more
- Intermountain Health (Pierre, SD)
- …on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health ... assistant- + Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within four (4) years of… more
- Evolent (Pierre, SD)
- …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... necessary/required. + Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as… more