• Medical Director - National

    Humana (Denver, CO)
    …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (03/11/25)
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  • Medical Director - Care Plus…

    Humana (Denver, CO)
    **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 (03/18/25)
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  • Physician Medical Director - LTSS

    Humana (Denver, CO)
    …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State ... community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical more
    Humana (01/25/25)
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  • Medical Director - Medicaid N.…

    Humana (Denver, CO)
    **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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (03/11/25)
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  • Senior Medical Director

    CVS Health (Aurora, CO)
    …with heart, each and every day. **Company:** Oak Street Health **Title:** Senior Medical Director **Location:** Various Oak Street Health is a rapidly growing, ... it should be. For more information, visit www.oakstreethealth.com. **Role Description:** The Senior Medical Director will join Oak Street Health at a critical… more
    CVS Health (03/18/25)
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  • Field Medical Director , Cardiology

    Evolent (Denver, CO)
    …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. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (02/14/25)
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  • Field Medical Director

    Evolent (Denver, CO)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (01/30/25)
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  • Behavioral Health Medical Director

    Humana (Denver, CO)
    …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
    Humana (02/15/25)
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  • Field Medical Director , Genetic…

    Evolent (Denver, CO)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
    Evolent (02/18/25)
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  • Fraud Waste and Abuse Division Director

    State of Colorado (Denver, CO)
    …sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, ... Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4857662) Apply  Fraud Waste and Abuse Division … more
    State of Colorado (03/08/25)
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  • Associate Medical Director

    Evolent (Denver, CO)
    …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... to drive meaningful change beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in… more
    Evolent (03/04/25)
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  • Associate Director - Value-Based Specialty…

    Humana (Denver, CO)
    …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
    Humana (03/04/25)
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  • Executive Director , Compliance

    NASCO (Denver, CO)
    **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the company's ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
    NASCO (02/11/25)
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  • Director , Competitive Intelligence, Stars

    Humana (Denver, CO)
    …will join the Health Quality and Stars (HQS) leadership team as the Director , Competitive Intelligence to drive the strategic vision of the company's Stars ... ideal candidate will possess a deep understanding of the Medicare landscape, strong analytical skills and the ability to...field + 8+ years of work experience in large national plans, strategic consulting, market analysis and/or finance +… more
    Humana (03/04/25)
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  • Risk Adjustment Compliance Director

    Humana (Denver, CO)
    …community and help us put health first** The Risk Adjustment Compliance Director ensures compliance with governmental requirements. The Risk Adjustment Compliance ... Director requires an in-depth understanding of how organization capabilities...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (03/11/25)
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  • Director , Technology Solutions (AEP)

    Humana (Denver, CO)
    …part of our caring community and help us put health first** The Director , Technology Solutions (AEP) will provide strategic direction, leadership, design and execute ... CenterWell umbrella of primary care services through mergers and acquisitions. The Director of Technology Solutions (AEP) is expected to bring experience in running… more
    Humana (03/15/25)
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  • Director , Home Health Financial Operations

    Humana (Denver, CO)
    …and be their most productive. Against that backdrop, we are seeking a Director of Financial Operations of Home Health Solutions who will provide program ... leadership can evaluate alternatives against the organization's business objectives. The Director of Financial Operations requires a strong understanding the Home… more
    Humana (03/15/25)
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  • Director , Long Term Strategic Planning

    Humana (Denver, CO)
    …of our caring community and help us put health first** The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic and ... the development of long-term growth plans and profitability goals The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic… more
    Humana (03/14/25)
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  • Senior Director - Benefit Operations

    Modivcare (Denver, CO)
    …may be the right fit for you! Modivcare is looking for an experienced Senior Director - Benefit Operations to join our team. This role is responsible for providing ... core processes critical to the administration and delivery of Non-Emergency Medical Transportation (NEMT) benefits, ensuring these processes align with client… more
    Modivcare (01/25/25)
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  • Director , Data Science

    Humana (Denver, CO)
    …Join us in shaping the future of healthcare through AI excellence. The Director of Data Science is responsible for spearheading the development and implementation of ... various departments, including data engineering, product, and business leaders. The Director will help identify opportunities for AI applications, oversee the… more
    Humana (03/18/25)
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