- Gossamer Bio (San Diego, CA)
- …with all federal and state pricing programs, including Medicaid, 340B, VA/FSS, and Medicare Part D reporting. Partner with Legal, Compliance, and Finance to ... Exec Director , Managed Markets & Payer Strategy Join to...strategy to ensure optimal coverage and reimbursement across Commercial, Medicare , and Medicaid channels. Reporting to the Vice President… more
- City of Pittsburgh (Pittsburgh, PA)
- …contract pensions. Reviews monthly check maintenance for accuracy. Assists in processing Medicare Part B inquiries and documentation for applicable retirees. ... of Directors is currently in search of an Executive Director . The Executive Director position serves a...position. Candidates who receive job offers must pass a medical examination (when applicable) prior to start date. Written:… more
- Humana Inc (Honolulu, HI)
- Become a part of our caring community and help us put health first The Associate Director , Technology Solution Implementation delivers new technological ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Vertex Pharmaceuticals (Boston, MA)
- Director , Market Access Strategy (Heme) page is loaded## Director , Market Access Strategy (Heme)locations: Boston, MAtime type: Full timeposted on: Posted ... Mediated Kidney Disease, and Duchenne Muscular Dystrophy, among others.The ** Director ,** **Market Access Strategy (Heme)** is accountable for leading, overseeing,… more
- ViiV Healthcare (San Francisco, CA)
- …variety of payers (AIDS Drug Assistance Program, Fee for Service Medicaid, Managed Medicaid, Medicare Part D, PBMs and PBAs as well as assigned Commercial ... until HIV/AIDS is eradicated. ViiV has played a significant part in delivering breakthroughs that have turned HIV into...and external) to support strategic objectives. This Regional Sales Director , Pacific will provide YOU the opportunity to lead… more
- Vertex Pharmaceuticals Incorporated (Boston, MA)
- …Mediated Kidney Disease, and Duchenne Muscular Dystrophy, among others. The Director , Market Access Strategy (Heme) is accountable for leading, overseeing, and ... Strategy (GVAS), and Marketing). This role will report into the Sr Director , Market Access Strategy, Heme. Provide critical leadership and project management in… more
- NHS Management (Prattville, AL)
- …practicable level for each resident. Provides case management services for certain high-risk Medicare Part A residents to ensure services are provided in ... Medicare assessments, following the current regulatory guidelines for assessments. Reviews Medicare Part A MDS assessments to ensure accuracy including;… more
- Christus Health (Santa Fe, NM)
- …interviews patients, obtain accurate demographic and financial information and check for medical necessity for all Medicare patients. Computer entry, preparing ... verbally in English. Laboratory equipment operation skills required. Knowledge of medical terminology. EXPERIENCE: Minimum of one year Lab experience required; five… more
- Elevance Health (Tampa, FL)
- ** Medical Director - Florida Medicare ...and expectations for time onsite will be discussed as part of the hiring process. The health of our ... must reside in Florida near our Miami or Tampa locations.** The ** Medical Director ** will support the following Florida Medicare plans: Simply Healthcare… more
- CVS Health (Hartford, CT)
- …the US.** **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part C appeals (both provider and ... * Board Certified in ABMS or AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience. *… more
- OhioHealth (Columbus, OH)
- …matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical ... belief system.** We believe wellness and sickness are both part of a lifelong partnership, and that everyone could...This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities.… more
- Humana (South Miami, FL)
- …must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work ... **Become a part of our caring community and help us...The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,… more
- Cleveland Clinic (Cleveland, OH)
- …the Federal Clinical Trials Policy. In this role, you will report to the Director of Research Medicare Coverage Analysis and ensure compliant research billing ... the most respected healthcare organizations in the world. As a Research Medicare Coverage Analysis Specialist, you will be responsible for determining qualifying… more
- Community Health Systems (La Follette, TN)
- …+ 1-2 years of experience in understanding the minimum requirements needed for Medicare billing, medical claims processing, or hospital revenue cycle operations ... **Job Summary** The Medicare Billing Specialist is responsible for performing timely...physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the… more
- Henry Ford Health System (Traverse City, MI)
- …is required. GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 ... planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for both… more
- Humana (Lincoln, NE)
- …to review Medicare drug appeals ( Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis ... of the Medicare rules, Humana policies and medical necessity. The Medical Director ...Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part… more
- Humana (Washington, DC)
- **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 (Raleigh, NC)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to ... 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
- Humana (Carson City, NV)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to ... 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
- Humana (Jefferson City, MO)
- …a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... 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
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