- Merck & Co. (North Wales, PA)
- …work model is combination of in-office and work from home) The Associate Director Market Access will work closely with agency partners, internal brand colleagues, ... and launch future mono-therapies and combination.- This role will report to the Director , Oncology Market Access. The Associate Director Market Access will be… more
- Elevance Health (Wilmington, DE)
- ** 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
- Humana (Trenton, NJ)
- …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 (Trenton, NJ)
- …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 (Blue Bell, PA)
- …skills and attention to detail **Preferred Qualifications** + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience with SAS, SQL, ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- Humana (Trenton, NJ)
- …and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation... Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify … more
- Humana (Trenton, NJ)
- **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 (Trenton, NJ)
- **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 (Trenton, NJ)
- **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
- Evolent (Trenton, NJ)
- …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 (Trenton, NJ)
- …Evolent 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
- CVS Health (Trenton, NJ)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Management staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for… more
- CSL Behring (King Of Prussia, PA)
- The Associate Director , Corporate Accounts (ADCA) is responsible for optimizing access, reimbursement, and profitability for CSL Behring's portfolio of brands in ... role in CSL Behring's commercial organization and reports to the Senior Director of Corporate Accounts. The ADCA is responsible for executing CSL Behring's… more
- Genesis Healthcare (Wyncote, PA)
- …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 PT is responsible for the efficient management of… more
- CVS Health (Blue Bell, PA)
- …Candidates must reside within commutable distance from a CVS or Aetna office.** The Medicare Stars and Health Equity team is seeking a Lead Dir, Health Equity & ... expanding on equity-based clinical and member experience initiatives leveraging existing Medicare product portfolio. Collaborate closely with the Medicare … more
- Humana (Trenton, NJ)
- …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
- Baylor Scott & White Health (Trenton, NJ)
- …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
- Humana (Trenton, NJ)
- …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
- Organon & Co. (Plymouth Meeting, PA)
- **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director , Regional Payer Accounts. The RPAD ... and programs. The primary customer/account responsibilities include key Regional Commercial and Medicare Health Plan accounts. The primary goal is to achieve desired… more
- Merck (North Wales, PA)
- …model is combination of in-office and work from home)** The **Associate Director Market Access** will work closely with agency partners, internal brand colleagues, ... and launch future mono-therapies and combination. This role will report to the Director , Oncology Market Access. The Associate Director Market Access will be… more
