- 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 ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Washington, DC)
- …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...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- CVS Health (Lansing, MI)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... 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 (Lansing, MI)
- …process, drive us to deliver unparalleled results. We are seeking an Executive Director to lead the newly formed **Group Medicare Performance Optimization** ... understanding of CMS regulations such as the Inflation Reduction Act (IRA), Medicare Prescription Payment Plan(M3P)as well as Indirect Medical Education (IME)… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …true colors to blue. Reporting to the SVP, Sales & Client Management, the Director , Group Medicare Sales, is an integral member of the leadership team-driving ... BCBSMA's purposeful re-entry into the Group Medicare Advantage Market. The role will have responsibility for Group Medicare Advantage and Medicare … more
- Molina Healthcare (Long Beach, CA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- CVS Health (Hartford, CT)
- …in new and exciting ways every day. Aetna is recruiting for an Executive Director , Actuarial who will be responsible for understanding and driving action on ... Medicare Network Insights and curating support for this important...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Nashville, TN)
- …implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of ... large product initiatives, including new products and product enhancements for Medicare formularies, UM and clinical tools for Medicare PDP, MAPD and employer… more
- The Cigna Group (Plano, TX)
- …TEXAS market - can live in Houston, San Antonio, Dallas or Plano** The ** Director , Provider Contracting - Medicare ** serves as an integral member of the ... for service and sophisticated value-based reimbursements with providers for Cigna's Medicare product lines (eg, Hospital systems, Ancillaries, and large physician… more
- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and ... the best version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO) + Professional… more