- Merck & Co. (North Wales, PA)
- Job DescriptionThe Associate Director Market Access will work closely with agency partners, internal brand colleagues, promotions, internal communications, pricing, ... and launch future key tumor indications. This role will report to the Director , Oncology Market Access.The Associate Director Market Access will be responsible… more
- Merck & Co. (North Wales, PA)
- Job DescriptionThe Associate Director , US Payer Marketing/ Oncology Market Access - Alliances will work closely with cross functional teams, alliance partners, ... indications for oral and infused medicines. This role will report to the Director , Oncology Market Access - Orals & AlliancesThe Associate Director , US… more
- Insmed Incorporated (Philadelphia, PA)
- …of the field-based Field Access team, and will report to the Director , Field Access Managers. This is a non-supervisory position.ResponsibilitiesA key component of ... launch experience preferred Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and coverage policy) Experience… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s status as a ... Founded in 1934, Medical Mutual is the oldest and one of...health and quality of life. Directs the Individual and Medicare Sales team policies and objectives to achieve sales… more
- CVS Health (St. Paul, MN)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... * Board Certified in ABMS Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience.… more
- CVS Health (Lansing, MI)
- …process, drive us to deliver unparalleled results. We are seeking an Executive Director to lead the newly formed **Group Medicare Performance Optimization** ... CMS regulations such as the Inflation Reduction Act (IRA), Medicare Prescription Payment Plan(M3P)as well as Indirect Medical...Degree required + Advanced Degree will be valued Location Remote - working East Coast hours **Pay Range** The… more
- Humana (Columbus, OH)
- …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...protect member PHI / HIPAA information This is a remote position reporting to Grievance and Appeals Director… more
- The Cigna Group (Bloomfield, CT)
- This is a ** Medicare Advantage position** WORK LOCATION: REMOTE position The **National Ancillary Medicare Advantage (MA) Provider Contracting Senior ... NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment....senior leadership both internally and externally to achieve total medical cost savings. + Responsible for collecting, documenting, and… more
- GEHA (Lee's Summit, MO)
- …meeting contractual and regulatory requirements. + Work in conjunction with the Vice President and Director of Pharmacy to align Medicare Part D / EGWP lines of ... Health Association, Inc., pronounced GEHA) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and… more
- Magellan Health Services (Dallas, TX)
- …MMUM). After Hours coverage may be required. General Job Information Title Medical Director , BH - TX licensed, Remote (part time) Grade 36 Work Experience - ... the health plan(s) for all lines of business (Medicaid, Medicare , and Commercial) and implements programs to support this...activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May… more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary The Senior Director Clinical Programs provides oversight and coordination of care management and disease ... objectives, and analysis for the Martin's Point Health Plan. The Senior Director is responsible for Care Management design, implementation and operations and will… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Not a Remote Position Position Purpose: This leadership position is responsible for the development, implementation and oversight of the Quality Improvement Program, ... member of the Quality Improvement Committee, Appeals and Grievance Committee, and Medical Management Committee. + Responsible for quarterly reporting to the Quality… more
- CenterWell (Columbus, OH)
- …Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead comprehensive clinical ... optimization and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare **Use your… more
- AbbVie (Chicago, IL)
- …on LinkedIn. Allergan Aesthetics | An AbbVie Company Job Description Associate Director , Market Access and Advocacy- Plastic Regenerative Medicine, will focus on the ... reimbursement. This position will call on commercial payors, managed care organizations, Medicare MACs, state Medicaid, Medicare Advantage and commercial plans… more
- AbbVie (Chicago, IL)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... Twitter, Facebook, Instagram, YouTube and LinkedIn. Job Description The Regional Director , BOTOX(R) Therapeutic - Neurosciences leads the sales performance and… more
- CareFirst (Baltimore, MD)
- …quality initiatives, compliance, population health, and/or member/provider experience. + Analyzes Medicare and Medicaid pharmacy and medical drug utilization ... **Resp & Qualifications** **PURPOSE:** Director , Pharmacy Government Programs is responsible for implementing...organization's pharmacy vision and strategic plan for government programs ( Medicare and Medicaid). This role has oversight of pharmacy… more
- CVS Health (Richmond, VA)
- …involved in local communities and leading the way in health care. The LTSS Director , Clinical Health Services ( Director ), will partner closely with the LTSS ... Director , Market CEO, DSNP Senior Leadership Clinical Health Services, Centers for Medicare and Medicaid Services, and State Agencies to build a transparent and… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... treatments for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United States, MTPA… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description ... Summary** Responsible for support and development of Medical Pharmacy program strategy as part of the Medical Pharmacy Business Development team. Responsible for… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on building a ... decentralized systems. * Google Cloud Professional Machine Learning Engineer * Agile Remote /WAH requirements: + WAH requirements: Must have the ability to provide a… more
