- CVS Health Corporation (Oklahoma City, OK)
- A leading health solutions company is seeking a Utilization Management Medical Director to support the Aetna Oklahoma Medicaid plan. This remote role ... have significant experience in direct patient care, hold an active Oklahoma medical license and possess board certification in Family Medicine, General Surgery, or… more
- Humana Inc (Des Moines, IA)
- A leading healthcare company is seeking a Medical Director to oversee compliance with Medicare and Medicaid services. The position involves conducting ... Strong communication and analytical skills are essential. This role includes remote work with occasional travel requirements. Competitive salary ranges from $223,800… more
- Humana Inc (Richmond, VA)
- A leading healthcare organization is seeking a Medical Director to oversee Medicare services. The ideal candidate will have an MD or DO, board certification, and ... medical interpretations, conducting case reviews, and improving medical management operations. This is a remote ...improving medical management operations. This is a remote position with occasional travel required. The salary ranges… more
- Humana Inc (Bismarck, ND)
- A leading healthcare provider is seeking a Medical Director to ensure compliance with national guidelines and provide medical interpretations for Medicare ... communication skills, and a minimum of 5 years clinical experience. This remote position may require occasional travel for training. The compensation ranges from… more
- Humana Inc (Carson City, NV)
- A leading healthcare organization is seeking a Medical Director responsible for the oversight of Medicare services. You will provide medical interpretations ... DO degree, board certification, and 5+ years of clinical experience. This remote position may involve occasional travel for training. Competitive salary from… more
- Humana Inc (Hartford, CT)
- A leading healthcare provider is seeking a Medical Director to oversee adherence to Medicare guidelines and provide medical interpretations. This role ... board certification, and 5+ years of clinical experience. The position is remote with occasional travel for meetings and training. Competitive compensation ranging… more
- Humana Inc (Columbus, OH)
- A leading healthcare organization is seeking a Medical Director to provide medical interpretation and decisions regarding healthcare services for the ... a board certification and 5+ years of clinical experience. The position offers remote flexibility with occasional travel for training or meetings. #J-18808-Ljbffr more
- Humana Inc (Boston, MA)
- A leading healthcare services company is seeking a Medical Director to oversee the review of home health and Medicare services. The role demands an MD or DO ... guidelines. The position offers a salary range between $223,800 and $313,100 annually, with remote work options and occasional travel for meetings. #J-18808-Ljbffr more
- Humana Inc (Columbia, SC)
- A healthcare organization is seeking a Medical Director to oversee medical interpretation and determinations for compliance with national guidelines and CMS ... regulations. Candidates should have a medical degree, board certification, and over 5 years of direct patient care experience. This position offers a competitive… more
- Humana Inc (Little Rock, AR)
- A leading healthcare organization is seeking a Medical Director to provide medical interpretations and ensure compliance with national guidelines. The ideal ... of clinical experience. The role involves conducting case reviews, making medical decisions, and operational improvements. Occasional travel to office meetings may… more
- Humana Inc (Dover, DE)
- A healthcare services company is seeking a Medical Director responsible for medical interpretation and compliance with guidelines in Dover, Delaware. The ... ideal candidate must have an MD or DO degree, board certification, and over 5 years of clinical experience. This role includes conducting case reviews, ensuring the appropriateness of services, and developing collaborative relationships within the Medicare… more
- Humana Inc (Baton Rouge, LA)
- A healthcare services provider is seeking a Medical Director to oversee Medicare-related clinical operations. The ideal candidate will ensure compliance with ... national guidelines and CMS regulations, while managing clinical case reviews. Requires an MD/DO, ongoing board certification, and extensive clinical experience. This role offers a competitive salary and the chance to make a significant impact within the… more
- Humana Inc (Honolulu, HI)
- A healthcare company is seeking a Medical Director to utilize their medical expertise for determining patient services authorization. Responsibilities ... include medical evaluations, compliance with regulations, and collaboration with healthcare...collaboration with healthcare teams while focusing on Medicare and Medicaid populations. Candidates must hold an MD or DO… more
- 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
- Humana Inc (Boston, MA)
- …and Medicaid requirements and operationalize this knowledge daily. The Medical Director 's work includes computer-based review of moderately complex to ... and outpatient services and equipment within their scope. The Medical Director may speak with contracted external...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical … more
- Humana Inc (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 Board… more
- Humana Inc (Frankfort, KY)
- … Director page is loaded## Grievances and Appeals Corporate Medical Directorlocations: Remote Kentuckytime type: Full timeposted on: Posted Todayjob ... a part of our caring community and help us put health first**The Corporate Medical Director provides medical interpretation and decisions about the… more
- Medical Home Network (Chicago, IL)
- …communities. If this sounds like you, we would love to have you apply as Director , Actuarial Services, with Medical Home Network! Since 2009, Medical Home ... Great Place to Work in 2025. THE OPPORTUNITY: The Director of Actuarial Services will apply a rigorous analytical...focused on evaluating and managing and forecasting risk within Medical Home Network's Medicare, Commercial and Medicaid … more
- Humana Inc (Chicago, IL)
- Director , Provider Contracting page is loaded## Director , Provider Contractinglocations: Remote Illinoistime type: Full timeposted on: Posted Yesterdayjob ... part of our caring community and help us put health first**The Director , Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other… more
- Gossamer Bio (San Diego, CA)
- Exec Director , Managed Markets & Payer Strategy Summary: The Executive Director , Managed Markets & Payer Strategy, is responsible for shaping and executing ... strategy to ensure optimal coverage and reimbursement across Commercial, Medicare, and Medicaid channels. Reporting to the Vice President of Market Access, this… more
