• Medicaid Director

    Iowa Department of Administrative Services (Des Moines, IA)
    Medicaid Director Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4701596)  Medicaid Director Salary $149,864.00 - $212,908.80 Annually ... Department's Director , who serves on Governor Reynolds' Cabinet, Iowa's State Medicaid Director is a key member of the Iowa HHS Executive Team, responsible… more
    Iowa Department of Administrative Services (01/03/25)
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  • Actuarial Director , Medicaid Trend…

    Humana (Des Moines, IA)
    …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
    Humana (01/03/25)
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  • Medical Director - Florida

    Humana (Des Moines, IA)
    …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
    Humana (12/14/24)
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  • Medical Director - National Medicare Team

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for services. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
    Humana (11/08/24)
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  • Medical Director - South Central

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
    Humana (11/08/24)
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  • Medical Director - Acute Rehab Team

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
    Humana (12/31/24)
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  • Medical Director - Mid West Region

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex… more
    Humana (10/29/24)
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  • Medical Director - OneHome/Home Heatlth

    Humana (Des Moines, IA)
    …community and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other… more
    Humana (12/21/24)
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  • Director Clinical Account Services - Remote…

    Prime Therapeutics (Des Moines, IA)
    …fuels our passion and drives every decision we make. **Job Posting Title** Director Clinical Account Services - Remote Nevada **Job Description Summary** Plays a key ... expertise with data management and overall healthcare trends specific to the Medicaid population. **Job Description** + Partners with appropriate staff in the… more
    Prime Therapeutics (11/06/24)
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  • Associate Director Cloud Architecture

    Humana (Des Moines, IA)
    …our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and ... and unstructured data to insights at enterprise scale. The Associate Director , Cloud Architecture requires an in-depth understanding of how organization capabilities… more
    Humana (11/02/24)
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  • Field Medical Director , Cardiology

    Evolent (Des Moines, IA)
    …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. We can ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
    Evolent (11/15/24)
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  • Medical Director - Commercial Appeals

    CVS Health (Des Moines, IA)
    …Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy implementation. ... ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied medical services.… more
    CVS Health (11/13/24)
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  • Director , Solutions Architecture

    Humana (Des Moines, IA)
    …a part of our caring community and help us put health first** The Director , Solutions Architecture works with partners across the organization to build a digital ... cloud service delivery and the architecture of digital customer experiences. The Director , Full Stack Engineering requires an in-depth understanding of how digital… more
    Humana (12/20/24)
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  • Associate Director , Actuarial

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** The Associate Director , Actuarial provides actuarial support across a broad range of actuarial and business ... needs for specific product lines. The Associate Director , Actuarial requires a solid understanding of how organization capabilities interrelate across department(s).… more
    Humana (12/12/24)
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  • Process Improvement Director -HEDIS

    Elevance Health (West Des Moines, IA)
    **Process Improvement Director -HEDIS** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1hour commute from the ... posted Elevance Health locations. This **Process Improvement Director -HEDIS** will be responsible for enterprise HEDIS improvement and governance programs, with… more
    Elevance Health (12/21/24)
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  • Associate Director , Data and Reporting

    Humana (Des Moines, IA)
    …part of our caring community and help us put health first** The Associate Director , Data and Reporting integrates data from multiple sources to produce requested or ... department(s) and leads multiple highly specialized professional associates. The Associate Director , Data and Reporting integrates data from multiple sources to… more
    Humana (01/04/25)
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  • Director , IT Portfolio Management…

    Humana (Des Moines, IA)
    …part of our caring community and help us put health first** The Director , IT Portfolio Management for Enterprise Information Protection (EIP) develops and executes ... technology and innovation to improve and mature Humana's security posture. The Director develops and executes on programs defined to implement security controls,… more
    Humana (12/14/24)
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  • Field Medical Director -General Surgery

    Evolent (Des Moines, IA)
    …the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , you will be a key member of the utilization management team. We can offer ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation,… more
    Evolent (12/09/24)
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  • Associate Director - Salesforce

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** As the Associate Director , Salesforce Technology, you will be at the forefront of devising and executing a ... committed to transforming Primary Care through technology and innovation. The Associate Director , Technology Solutions acts as a liaison and collaborates with the… more
    Humana (11/26/24)
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  • Director of Data Science (Remote Eligible)

    Mathematica (Des Moines, IA)
    …our benefits here: https://www.mathematica.org/career-opportunities/benefits-at-a-glance We are seeking a motivated * Director of Data Science* to lead a practice of ... will eventually work with some of our largest clients, including the Centers for Medicaid & Medicare Services (CMS) and other agencies. Most staff working on these… more
    Mathematica (11/21/24)
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