- Merck & Co. (North Wales, PA)
- …into innovative medicines that help people around the globe. The Associate Director , US Payer Marketing, is responsible for developing market access strategies and ... value evidence planning. - In this role, the Associate Director will also collaborate with Global Market Access and...US payer customer segments (health plan, PBM, ADAP, Medicaid, Medicare , federal, pharmacy, hospital and GPO) Develop pricing and… more
- 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
- Novo Nordisk Inc. (Plainsboro, NJ)
- …of Excellence for Scenario Planning and Modeling. The Advisory is led by a director and structured to act as a hub, bringing together cross-functional teams such as ... be responsible for supporting and optimizing approved strategies across Commercial and Medicare channels and customers with the designated SPC Account Lead, as well… more
- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution ... experience required. + Proven experience with commercial and/ or Medicare Advantage risk adjustment functions. + Proven track record of working collaboratively… more
- The Cigna Group (Nashville, TN)
- …of the National Development and Network Solutions team, reporting directly to the Medicare National Partnerships Director . This role is a key contributor for ... and Medicare Advantage stakeholders for complex value-based and downside risk reimbursement methodologies for Medicare provider contracting matters. +… more
- Travelers Insurance Company (Columbus, OH)
- …strategies for addressing and resolving various types of debt, including Medicare , to deliver positive financial outcomes. This role requires leveraging economic ... Support: + Partners with the Field, Claim Resources and Senior Leadership to identify and improve Claim processes and...a financial management and control strategy to limit financial risk associated with claim costs. + Serves as a… more
- The Cigna Group (St. Louis, MO)
- …Risk Adjustment Operations Senior Advisor will report to the Stars and Risk Adjustment Managing Director and will be responsible for internal and external ... actions into a synthesized set of business updates and strategies for a senior executive-level audience. Ideally this high-potential candidate uses this role as a… more
- The Cigna Group (Atlanta, GA)
- …Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director , this individual ensures the effective ... from local office 3 days per week.** The Provider Performance Enablement Senior Advisor is an integral part of a cross-functional, collaborative organization (which… more
- Banner Health (Phoenix, AZ)
- …Health Services Organization (PHSO), will serve as the clinical DYAD to the Executive Director of Risk Adjustment, co-leading a robust team that will support the ... and develops clinical strategies and educational initiatives around the impact that accurate risk adjustment has on the performance of our MA, MSSP, Medicaid, and… more
- CenterWell (Carson City, NV)
- …of our caring community and help us put health first** The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, ... (CMS), other payers, and over government agencies. In addition, the Associate Director , Risk Adjustment oversees all medical coding education activities. The… more
- Prime Therapeutics (Columbus, OH)
- …vision, depth perception and ability to adjust focus **Reporting Structure** + Reports to Senior Principal or Senior Director in the Finance department ... and drives every decision we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal Actuary is responsible for… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Senior Director Regulatory and Accreditation? At HCA Healthcare, you come first. HCA ... make a difference. We are looking for a dedicated Senior Director Regulatory and Accreditation like you...and provides guidance to division vice president, quality or director , quality and risk management *Daily prioritization… more
- ChenMed (Detroit, MI)
- …and mission-driven, primary care organization, is currently one of the most successful full- risk Medicare Advantage providers in the nation and has a vision ... position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization....each patient in their panel of at least 300 risk adjusted patients (75% partial panel). They understand that… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Senior Director - Actuary collaborates with stakeholders from across the organization and leads a team of directors and/or analysts to ... develop sophisticated risk management analytics that provide information, insights, and BI...assessment, decision-making, goal setting, and effective performance measurement. The Senior Director - Actuary will be a… more
- The Cigna Group (Maitland, FL)
- …Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, Provider Relations, and ... Network Development & Solutions). Reporting to the Provider Performance Director , the Provider Performance Manager ensures the effective management of the… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …national antifraud associations. The attorney will also oversee compliance for the Medicare and Federal Employee programs related to FWA and respond to Compliance, ... CMS and OPM requests and audits. The attorney will provide risk management advice, legal advice and litigation services to other areas of the Blue Cross as needed.… more
- ConvaTec (Bridgewater, NJ)
- …all the time. We're a business that never stands still. Join the team as the Director / Senior Director , US Policy and Global Market Access and Reimbursement - ... range of benefits, from infection prevention and protection of at- risk skin, to improved patient outcomes and reduced care...note, this position could be hired at either a Director or Senior Director level… more
- The Mount Sinai Health System (New York, NY)
- …for value-based contracts including Medicare , Medicaid and commercial arrangements. The Senior Director is a key member of Mount Sinai Health Partners, ... **JOB DESCRIPTION** The Senior Director , Contract Performance is responsible...implementing and driving performance for value-based contracts inclusive of risk and opportunity identification for Medicare , Medicaid… more
- The Cigna Group (Philadelphia, PA)
- …Stars and RA goals and objectives. This position reports to the Managing Director of Stars, Risk Adjustment, and Interoperability. The successful candidate for ... other day of choosing)** **Summary:** This position will focus on Stars and Risk Adjustment (RA) performance and solution enablement activities, with an emphasis on… more
