- Humana (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …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...rendered by healthcare professionals in compliance with CMS guidelines, clinical coverage criteria, and quality standards. Represents Humana at… more
- CenterWell (Phoenix, AZ)
- …part of our caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic pharmacy leader responsible for developing, ... Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: +...(SME) and clinical liaison to the national clinical leadership (including Chief Medical Officer, Complex… more
- Prime Therapeutics (Phoenix, AZ)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description ... Medical Pharmacy clients and potential new clients. Required to serve as a Medical Pharmacy clinical resource throughout the organization and support all … more
- Humana (Phoenix, AZ)
- **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...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Phoenix, AZ)
- **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
- Humana (Phoenix, AZ)
- … Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** The _Associate Director - Pharmacy Clinical Program Trend_ will be part of an interactive team ... with broad exposure and scope within Humana. The _Associate Director - Pharmacy Clinical Program Trend_ will...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Phoenix, AZ)
- **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… more
- Humana (Phoenix, AZ)
- …& Supports or LTC/SNF with 5+ years of experience preferred **Additional Information** The Medical Director conducts clinical reviews of the care received by ... caring community and help us put health first** The Medical Director 's primary responsibility is the review...an in-depth evaluation of variable factors that rely on clinical experience and knowledge of both medicine and social… more
- Boehringer Ingelheim (Phoenix, AZ)
- …expectations for insight generation related to scientific objectives. + In collaboration with Medical Excellence, the MSL Director and TA Sr. AD MSLs, identify ... within Medicine and across stakeholders, and support the MSL Director in accountabilities and key initiatives. + Collaborate with...- required. + 8 or more years' of relevant medical affairs experience, clinical practice, or research:… more
- Banner Health (Phoenix, AZ)
- …as part of Banner's Population Health Services Organization (PHSO), will serve as the clinical DYAD to the Executive Director of Risk Adjustment, co-leading a ... a strong knowledge and understanding of managed care operations, reimbursement models, medical protocols and criteria including Medicare criteria, and peer… more
- Prime Therapeutics (Phoenix, AZ)
- …and drives every decision we make. **Job Posting Title** Trade Client Strategy Director - Remote **Job Description** The Trade Client Relations Director is ... responsible for the analysis, modeling and delivery of innovative pharmacy and medical rebate strategies and cost saving solutions to Prime's clients to ensure Prime… more
- Cardinal Health (Phoenix, AZ)
- …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
- Prime Therapeutics (Phoenix, AZ)
- …of utilization management decisions. + On a requested basis, may function as Medical Director for select health plans or regions, assuming overall accountability ... as needed to discuss cases and problems. + Utilizes medical / clinical review guidelines and parameters to assure... Affairs. + Other duties as assigned. **Responsibilities** + Medicare Part D experience preferred. + Doctor of Medicine… more
- Banner Health (Phoenix, AZ)
- …of medical terminology and working knowledge of commercial and Medicare benefit coverage. Excellent communication and interpersonal skills. Ability to negotiate ... Transplant Finance Lead, you responsible for the financial activities of the clinical Transplant and Mechanical Circulatory System (MCS) programs at Banner -… more
- Aveanna (Phoenix, AZ)
- …work and documentation with accuracy and within Premier time frames Assists the Clinical Director with maintaining compliance as directed Actively listens and ... Operations Specialist - Medical Records & Payroll ApplyRefer a FriendBack Job...and external clients as it relates to branch location's clinical operational support activities. Compensation:$21/HR, plus monthly incentive potential… more
- CenterWell (Phoenix, AZ)
- … medical expertise with the care team through daily huddles. + Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- CenterWell (Mesa, AZ)
- … medical expertise with the care team through daily huddles. * Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- The Cigna Group (Scottsdale, AZ)
- …and rates. + Enhance the Facility Center of Excellence Program along with with Network Medical Director and Clinical Operations which include but not limited ... facility systems as well as construct a united negotiation strategy with our Medical Commercial and Medicare contracting and Network Strategy Leadership. +… more