Medicaid Medical Director — North Central

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 where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses...

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting Title North Carolina Medicaid Account Manager - Remote Raleigh, NC Job Description The Senior Account Manager is responsible for providing complex level support for the...

A national health insurance company is seeking a Medical Director to oversee clinical determinations and ensure compliance with healthcare standards. This role involves a blend of remote work and occasional travel, requiring a robust medical background, excellent communication skills, and experience in patient care. The ideal candidate will have an MD or DO...

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 make determinations whether requested services, requested level of care, and/or requested site of service should be authorized at the Inpatient level. All work occurs within a context of regulatory...

Join our caring community and help us prioritize health! The Medicaid (PPS) Provider Hospital Reimbursement Analyst, also known as a Senior Business Intelligence Engineer, is a vital member of the Pricer Business and System Support team. This role encompasses managing complex Medicaid provider reimbursement methodologies while supporting both ongoing...

A leading healthcare company is seeking a Senior Account Manager for the North Carolina Medicaid business. This remote role requires strong client management skills, with responsibilities including resolving issues, managing stakeholder engagements, and optimizing pharmacy spending. A Bachelors degree and at least 5 years of account management experience are...

Medicaid Member Support Call Center CsrThis is a remote position must be able to work MST business hoursHours: Monday Friday 8am 5pm MSTPayrate: $17 per hour, which may be below your state's minimum wage. Please take this into consideration when applying.Interested in supporting Medicaid members in Montana? Conduent has immediate openings for Call Center...

The North Central AHEC Program Specialist develops, implements, and evaluates programs and activities that support the AHEC mission to recruit, train, and retain a health profession workforce committed to underserved populations. Pipeline Programs Develops, implements, and evaluates pipeline programs to generate interest in and increase awareness of...

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 to complex issues where the analysis of situations or data requires a case by case consideration of the Medicare rules, Humana...

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 where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses...