• Medical Director - National

    Humana (Salem, OR)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
    Humana (08/29/24)
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  • Behavioral Health Medical Director

    Humana (Salem, OR)
    …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 (08/07/24)
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  • Medical Director - Medicare

    CVS Health (Salem, OR)
    …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...Board Certified in ABMS Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance &… more
    CVS Health (08/31/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Salem, OR)
    …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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
    Humana (08/10/24)
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  • Medical Director - Mid West Region

    Humana (Salem, OR)
    **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 (08/27/24)
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  • Medical Director - South Central

    Humana (Salem, OR)
    **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 (08/08/24)
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  • Medical Director - Medical

    CVS Health (Salem, OR)
    …**Position Summary** CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
    CVS Health (08/31/24)
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  • Medical Director - Acute Inpatient…

    Humana (Salem, OR)
    **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 (08/27/24)
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  • Medical Director - Clinical Services

    CareOregon (Portland, OR)
    Job Title Medical Director - Clinical Services Department Medical Management Administration Exemption Status Exempt Requisition # 24536 Direct Reports N/A ... Manager Title Sr Medical Director - Clinical Services Pay &...quality of care for a special needs, dually eligible Medicare population by understanding and applying D-SNP Medicare more
    CareOregon (08/22/24)
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  • Associate Medical Director

    CareOregon (Portland, OR)
    …a federal contractor and must comply with all federal laws. Job Title Associate Medical Director - Maternal, Child, and Youth Department Medical Management ... Exempt Requisition # 24391 Direct Reports N/A Manager Title Medical Director , CPCCO Pay & Benefits Estimated...Quadruple Aim. Direct support may be focused on Medicaid, Medicare , or Maternal, Child, and Youth Strategy lines of… more
    CareOregon (07/02/24)
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  • National Director , Clinical…

    CenterWell (Salem, OR)
    …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic...and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare more
    CenterWell (07/27/24)
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  • Senior Associate Director , Medical

    Boehringer Ingelheim (Portland, OR)
    …expectations for insight generation related to scientific objectives. + In collaboration with Medical Excellence, the MSL Director and TA Sr. AD MSLs, identify ... programs reflect Boehringer Ingelheim's high regard for our employees. The Sr. AD, Medical Science Liaison will manage a regional therapeutic area specific MSL team.… more
    Boehringer Ingelheim (09/11/24)
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  • Director , Actuarial of Medicaid Pricing

    Humana (Salem, OR)
    …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 in-depth understanding of how organization capabilities interrelate… more
    Humana (08/15/24)
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  • Director , Specialty Clinical Solutions-…

    Prime Therapeutics (Salem, OR)
    …legislative/oversight bodies (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA- National Committee for ... passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary**… more
    Prime Therapeutics (08/23/24)
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  • Director , Managed Care - Navista

    Cardinal Health (Salem, OR)
    …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
    Cardinal Health (08/14/24)
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  • Director , Medicaid Product Management…

    Humana (Salem, OR)
    …providing frameworks to maximize available resources to achieve growth. The ** Director ,** **Medicaid Insurance Product Management and Wellness Strategy** will have ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
    Humana (09/11/24)
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  • Director Cybersecurity Engineering(Metrics…

    Humana (Salem, OR)
    …a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on building a ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
    Humana (08/29/24)
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  • Associate Director , Enterprise API…

    Humana (Salem, OR)
    …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 ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
    Humana (08/28/24)
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  • Sr. Director , Regulatory Compliance

    HealthEdge Software Inc (Salem, OR)
    …NCQA ( National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other ... to solve critical needs in healthcare. This individual will report to the Chief Medical Officer of Healthedge (HE) and ensure that our clinical suite of products… more
    HealthEdge Software Inc (09/06/24)
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  • Physician - Primary Care

    CareOregon (Portland, OR)
    …HCP Providers Exemption Status Exempt Requisition # 24411 Direct Reports N/A Manager Title Medical Director - Primary Care Pay & Benefits Estimated hiring range ... as roughly 10,000 baby boomers a day enter the Medicare system. Job Summary This position provides medical...non-physician providers as needed and/or as directed by the Medical Director . Care is provided in patient… more
    CareOregon (07/20/24)
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