- Humana (Harrisburg, PA)
- **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...Qualifications** + MD or DO degree + **Valid Florida Medical license** + 5+ years of direct clinical… more
- Humana (Harrisburg, PA)
- …Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Wellpath (Somerset, PA)
- …They ensure necessary documentation of services is provided to the Site Medical Director ordesigneetomonitorthe provision of clinical services. Additionally, ... a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We...Nurse Practitioner (NP) under the supervision of the Site Medical Director and other site Physicians, offers… more
- Merck (Harrisburg, PA)
- **Job Description** **Role Summary** + The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Evolent (Harrisburg, PA)
- …non- clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Wellpath (Albion, PA)
- …with industry standards and company policies. + The Medical Director 's commitment to excellence extends to providing clinical oversight, participating ... a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We...care support. **How you make a difference** As a Medical Director , you will play a pivotal… more
- Pfizer (Collegeville, PA)
- …provider and/or patient knowledge gaps, and areas for quality improvementinterventions. The Director will develop, in conjunction with Medical team colleagues, ... **ROLE SUMMARY** Reporting to the US Specialty Care (US SC) Medical Lead for Gastroenterology, Biosimilars, and Rheumatology within headquarters, the Dir,… more
- Evolent (Harrisburg, PA)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... a physician`s input is needed or required. Responsible for clinical audits for quality and education regarding the results...questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into… more
- Evolent (Harrisburg, PA)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... within the regulatory timeframe of the request. + Utilizes medical / clinical review guidelines and parameters to assure...utilization management while working in conjunction with the Senior Medical Director . May assist the Senior … more
- YesCare Corp (Philadelphia, PA)
- …regular physicians. Below is a list of your responsibilities as a **Site Medical Director with YesCare at the Philadelphia Industrial Correctional Center, ... to validate need for non-formulary medication on non-formulary request form for Medical Director 's approval when non-formulary medication is ordered. + Utilizes… more