- habitathealth (San Francisco, CA)
- …network expansion. If you have network expansion experience, please apply to the Director , Network Role on our careers page. Additionally, you must have experience ... with proven experience managing and leading expansion processes for Medicare or Medicaid products and/or care delivery solutions, and who is passionate about… more
- Gossamer Bio (San Diego, CA)
- Exec Director , Managed Markets & Payer Strategy Join to apply for the Exec Director , Managed Markets & Payer Strategy role at Gossamer Bio The Executive ... Director , Managed Markets & Payer Strategy, is responsible for...ensure optimal coverage and reimbursement across Commercial, Medicare, and Medicaid channels. Reporting to the Vice President of Market… more
- ViiV Healthcare (San Francisco, CA)
- …products across a variety of payers (AIDS Drug Assistance Program, Fee for Service Medicaid , Managed Medicaid , Medicare Part D, PBMs and PBAs as well as ... and external) to support strategic objectives. This Regional Sales Director , Pacific will provide YOU the opportunity to lead...and Outlook as well as Customer Relationship Management Tools #LI- Remote * If you are based in Cambridge, MA;… more
- Humana Inc (Honolulu, HI)
- …our caring community and help us put health first The Associate Director , Technology Solution Implementation delivers new technological solutions to meet business ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Clarity Pediatrics, Inc. (San Francisco, CA)
- …platform Unique care product - condition‑specific, group‑based care built for Medicaid and commercial populations, in English and Spanish High‑trust, high‑leverage ... VCs who invested early in category winners like One Medical , Hims, Spring Health, Cityblock, Alto Pharmacy, Strava and...referral strategy: Work with our VP Commercial and Sales Director to map, design, and optimize our referral GTM… 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Centene Corporation (Olympia, WA)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Evolent (Phoenix, AZ)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Option Care Health (Madison, WI)
- …and brightest talent in healthcare. **Job Description Summary:** The Specialty Sales Director will develop and implement the Specialty business sales plan that ... geographic area of responsibility. It will be imperative for the Specialty Sales Director to work closely with the other Sales Directors and the Vice Presidents… more
- Stanford Health Care (Palo Alto, CA)
- …America) **This is a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's Office, ... Department of Health Care Access and Information (HCAI) In addition, the Director of Reimbursement oversees the organization's responses to government audits and… more
- Integra Partners (Troy, MI)
- The Senior Medical Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is ... require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads medical… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with… more
- Humana (Raleigh, NC)
- **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
- Humana (Carson City, NV)
- **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
- Humana (Jefferson City, MO)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Oklahoma City, OK)
- …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...internal teaching conferences, and other reference sources + Learns Medicaid requirements and understands how to operationalize this knowledge… more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the ... and determining the best course of action. The Corporate Medical Director provides medical interpretation...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- Humana (Lincoln, NE)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- State of Michigan (MI)
- Physician Manager 20 - Medical Director Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4848644) Apply Physician Manager 20 - Medical ... a career at MVH, please click here (https://www.youtube.com/watch?v=o92V-nOxaKs) . Serve as Medical Director for Michigan Veteran Homes (Grand Rapids or… more
