- Humana (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- … Medicaid Services) requires regulatory changes during the plan year. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** ensures accountability for ... Individual general enrollment, Special Needs Plans (SNP) and Employer Groups. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** acts as the… more
- CVS Health (Hartford, CT)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Regulated Medicare Appeals: * Direct daily work on ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...* Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance &… more
- CVS Health (Hartford, CT)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Part C Medicare Appeals. This position is primary ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...Board Certified in ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance &… more
- Humana (Hartford, CT)
- **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 (Hartford, CT)
- …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 (Hartford, CT)
- **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
- Evolent (Hartford, CT)
- …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 (Hartford, CT)
- …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
- Humana (Hartford, CT)
- …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
- Evolent (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …workflows to enhance accuracy and productivity. * Collaborate closely with the SIU Medical Director to align coding practices with organizational goals. * Work ... care more personal, convenient and affordable. **Position Summary:** As the Coding Director , you will oversee the coding operations, ensuring accurate and efficient… more
- National Health Care Associates (Glastonbury, 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...Bonus** **RN- MDS** **What You'll Do:** As an MDS Director , you will manage the Minimum Data Set (MDS)… more
- Evolent (Hartford, CT)
- …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
- Humana (Hartford, CT)
- …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
- Arvinas (New Haven, CT)
- …value of our products is fully understood. This position reports to the Executive Director of Strategic & National Accounts and will be performed remotely from ... important member of the Arvinas Market Access Team, the ** Director , Payer Accounts** will be a key contributor to...the Arvinas relationship and engagement with targeted regional and national payers including Commercial, Medicare and Medicaid… more
- NASCO (Hartford, CT)
- **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
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …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