- Humana (Trenton, NJ)
- …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 to complex issues...authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources which… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources, which...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will… more
- Humana (Trenton, NJ)
- …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 and complexity ranging...and appropriateness of services rendered by healthcare professionals in compliance with CMS guidelines, clinical coverage criteria, and quality… more
- Merck (North Wales, PA)
- **Job Description** The ** Associate Director ,** **US Payer Marketing/ Oncology Market Access - Alliances** will work closely with cross functional teams, ... report to the Director , Oncology Market Access - Orals & Alliances The Associate Director , US Payer Marketing/ Oncology Market Access will be responsible for… more
- Merck (North Wales, PA)
- **Job Description** The ** Associate Director Market Access** will work closely with agency partners, internal brand colleagues, promotions, internal ... to the Director , Oncology Market Access. The Associate Director Market Access will be responsible...partners and focus on customer segments (eg health plans, Medicare , Medicaid, federal, pharmacy, hospital, Group Purchasing Organization s,… more
- Penn Medicine (Philadelphia, PA)
- …our future each day. Are you living your life's work? Summary: + The Associate Director ("AD") will assist in the planning, development, coordination and ... Responsibilities: + Provide oversight and develop a strategic plan along with Director of Retail Pharmacy Operations for outpatient pharmacy services in all… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
- Humana (Trenton, NJ)
- …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 ... requires an in-depth evaluation of variable factors. **Job Profile** The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Trenton, NJ)
- …**Additional Information** Typically reports to a Lead, may also report to a Regional/ Associate Vice President or Corporate Medical Director , depending on size ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Trenton, NJ)
- …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 (Trenton, NJ)
- …us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and document ... work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality audits, prior authorization list… more
- Penn Medicine (Berwyn, PA)
- …and administrative functions of their individual laboratory section(s); ensure compliance with institutional and laboratory policies and procedures; evaluate and ... functions with residents and Medical Laboratory Science Students. + **Regulatory Compliance ** : Works with the Division's Quality Assurance manager in functioning… more
- Penn Medicine (Philadelphia, PA)
- …process per the CMS guidelines to ensure that PeriOperative Services is in compliance with Medicare reporting requirements and UPHS Office of Compliance2. ... you living your life's work? Summary: + In conjunction with Administrative Director of Operations, provides leadership, administrative support and management for the… more