- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Hartford, CT)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- CVS Health (Hartford, CT)
- …process, drive us to deliver unparalleled results. We are seeking an Executive Director to lead the newly formed **Group Medicare Performance Optimization** ... understanding of CMS regulations such as the Inflation Reduction Act (IRA), Medicare Prescription Payment Plan(M3P)as well as Indirect Medical Education (IME)… more
- Humana (Hartford, CT)
- …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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- CVS Health (Hartford, CT)
- …in new and exciting ways every day. Aetna is recruiting for an Executive Director , Actuarial who will be responsible for understanding and driving action on ... Medicare Network Insights and curating support for this important...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Hartford, CT)
- …health care more personal, convenient and affordable. **Position Summary** The Lead Director , Project Program Management will lead a cross-functional team focused on ... delivering large, complex strategic initiatives for the Medicare Organization. In a matrix management capacity, you will...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Hartford, CT)
- **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
- CVS Health (Hartford, CT)
- …**Position Summary** CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Humana (Hartford, CT)
- **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
- CenterWell (Hartford, CT)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic...and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare … more
- CVS Health (Hartford, CT)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and services for aligned plan's members. Position Description: Aetna Medicare Duals Center of Excellence is searching for a...the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- National Health Care Associates (Seymour, CT)
- …understanding of Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements + Interest in the nursing needs of the aged and the ... **-** **A Great Place to Work** ** National Health Care Associates is proud to welcome...& Rehabilitation!** **-** **What You'll Do:** As an MDS Director , you will manage the Minimum Data Set (MDS)… more
- National Health Care Associates (Milford, CT)
- …understanding of Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements + Interest in the nursing needs of the aged and the ... Place to Work** Milford is a proud affiliate of National Health Care Associates. As a Certified Great Place...our team! **-** **What You'll Do:** As an MDS Director , you will manage the Minimum Data Set (MDS)… more
- CVS Health (Hartford, CT)
- …Process Insights and Reengineering (APIR) team is functional unit of the Medicare Member Experience organization that engages with various business areas to mine ... As a key member the APIR team, the Lead Director will be expected to: + Serve as a...states. + Establish qualitative and quantitative connections between the Medicare member journey and the underlying business processes and… more
- Humana (Hartford, CT)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Prime Therapeutics (Hartford, CT)
- …legislative/oversight bodies (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA- National Committee for ... passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary**… more
- Cardinal Health (Hartford, CT)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Elevance Health (Wallingford, CT)
- **Process Improvement Director -Enterprise HEDIS** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1hour commute ... from an Elevance Health location. The **Process Improvement Director -Enterprise HEDIS** is responsible for identifying opportunities for improvement, developing and… more
- Humana (Hartford, CT)
- …providing frameworks to maximize available resources to achieve growth. The ** Director ,** **Medicaid Insurance Product Management and Wellness Strategy** will have ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more