- Highmark Health (Salt Lake City, UT)
- …:** Highmark Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Humana (Salt Lake City, UT)
- …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...requires an in-depth evaluation of variable factors. **Become a part of our caring community and help us put… more
- Humana (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...good faith estimate of starting base pay for full time (40 hours per week) employment at the … more
- Humana (Salt Lake City, UT)
- **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...good faith estimate of starting base pay for full time (40 hours per week) employment at the … more
- Humana (Salt Lake City, UT)
- **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...good faith estimate of starting base pay for full time (40 hours per week) employment at the … more
- Humana (Salt Lake City, UT)
- …clinical expertise to review Medicare drug appeals ( Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... case-by-case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director 's...Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D… more
- Humana (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse...a remote position. **Scheduled weekly hours** **:** 40 hours (full- time ): four 10-hour workdays per week, either Friday-Monday or… more
- Evolent (Salt Lake City, UT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... state. Multiple opportunities for a flexible schedule and both part - time and full- time options available.**...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Salt Lake City, UT)
- …lead Medical Directors performing utilization management for inpatient authorizations training medical director team to assist and facilitate new hires and ... **Become a part of our caring community and help us...rate with denials and overturns. Deliver the upmost consistent medical director decision making. + _Internal Operations… more
- Humana (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse...good faith estimate of starting base pay for full time (40 hours per week) employment at the … more