- Humana (Salt Lake City, UT)
- **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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Salt Lake City, UT)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- Cognizant (Salt Lake City, UT)
- **About the role** **Schedule:** M-F **Traveling Required:** 40% As a Medicaid Eligibility Delivery Director , you will make an impact by overseeing access, ... wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in United States. Regardless of your… more
- Evolent (Salt Lake City, UT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Salt Lake City, UT)
- **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 (Salt Lake City, UT)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Salt Lake City, UT)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Salt Lake City, UT)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- CenterWell (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical … more
- Humana (Salt Lake City, UT)
- …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...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- Humana (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- Merck (Salt Lake City, UT)
- **Job Description** Associate Director , Field Access Management The Associate Director , Field Access Management serves as the leader to a team of subject-matter ... Management Team for which you are responsible. * Understand Regional Payor and Medicaid coverage and provide market access education via approved materials to the… more
- Humana (Salt Lake City, UT)
- …our caring community and help us put health first** The Associate Director , Finance Data Management supports all aspects of configuration control, data management, ... and deficiency reporting. The Associate Director , Finance Data Management requires a solid understanding of...PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Humana (Salt Lake City, UT)
- …our caring community and help us put health first** The Director , General Accounting performs general accounting activities, including the preparation, maintenance ... Conducts or assists in the documentation of accounting projects. The Director , General Accounting requires an in-depth understanding of how organization capabilities… more
- Sumitomo Pharma (Salt Lake City, UT)
- …a dynamic, highly motivated, and experienced individual for the position of Associate Director , Market Access Engagement - Rare Disease, who will act as the face ... various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove reimbursement barriers to treatment + Build and maintain strong… more
- Molina Healthcare (West Valley City, UT)
- …Tighter knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates Complex Provider contracts including but not ... and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract… more
- Molina Healthcare (West Valley City, UT)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, and local health plan resources. + Responsible ... in value-based program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment,… more
- Danaher Corporation (Salt Lake City, UT)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE ) position is a provider / customer facing role responsible for ... to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the...Value and Access team. This position will be a remote position ideally located in the western part of… more
- Public Consulting Group (Salt Lake City, UT)
- …issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist with other ... errors and denied claim research results, final remittance advice processing, and medical record reviews that will include discussion with internal management to… more
- Cardinal Health (Salt Lake City, UT)
- …of Cardinal Health. This is a high-impact role reporting to the Director of Business Transformation and Change Management. This consultant will be responsible ... Payors, PBMs, Specialty Hubs, Patient Services, Patient Assistance Programs, Medicaid , and Pharmacy Operations. . Exceptional communication, executive presence,… more