- Conviva (San Juan, PR)
- **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (San Juan, PR)
- …and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical ... a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (San Juan, PR)
- …our caring community 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 episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and determinations… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...clinical standards, and (in some cases) contracts. Primary work reviewing prior-authorization reviews as well as some claims and… more
- Cardinal Health (San Juan, PR)
- **JOB TITLE:** Director , Compensation **Track / Level:** M3 **At Cardinal Health, we're developing the innovative products and services that make healthcare safer ... and communicates policies to managers throughout the enterprise. The Director , Compensation will drive broad-based and sales compensation for Pharma/Specialty… more
- Takeda Pharmaceuticals (San Juan, PR)
- …and building appropriate global regulatory strategy. + Preferred experience includes reviewing , authoring, or managing components of both drug and device regulatory ... or long-term incentives. US based employees may be eligible to participate in medical , dental, vision insurance, a 401(k) plan and company match, short-term and… more
- WM (San Juan, PR)
- …guidance, direction and recommendations to field operations by preparing and reviewing compliance reports, permit applications and draft permits. The team supports ... tracking and updates; and training. This position will report to the Senior Director of Air Programs and take direction from, coordinate with and/or assist Senior… more
- System One (San Juan, PR)
- …for federal grant consideration, under the direction of the Senior Director , Media Technology & Service Strategies. **Duties & Responsibilities** + Evaluates ... documentation. + Strong analytical skills, with attention to detail in reviewing technical budgets, identifying variances, and providing solutions. + Excellent… more
- Evolent (San Juan, PR)
- …at Evolent will serve as a point of contact for processing medical treatment requests in accordance with departmental policies, regulatory requirements, and client ... clinical team, which includes our Nurse, Clinical Reviewers and Field Medical Directors. Opportunities to work collaboratively with other Clinical Operation Leaders… more
- Evolent (San Juan, PR)
- …operations this individual also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: ... work collaboratively with other Utilization Management Leaders including our Director may also be available. **What You Will Be...also be available. **What You Will Be Doing:** + Reviewing internal workflows and policies to determine if submitted… more