- Humana (Phoenix, AZ)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, ... Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Sedgwick (Phoenix, AZ)
- …review process including making a recommendation of specialty for the Independent Medical Review process. + Developing and delivering training materials and ... Best Workplaces in Financial Services & Insurance Sr VP Medical Director (Hourly) The ideal candidate would work 8-20...required to include one (1) to three (3) years utilization review experience and three (3) years… more
- Humana (Phoenix, AZ)
- …clinical group practice management + Utilization management experience in a medical management review organization, such as Medicare Advantage and managed ... management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present… more
- Highmark Health (Phoenix, AZ)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may… more
- Humana (Phoenix, AZ)
- …group practice management + Utilization management experience in a medical management review organization such as Medicare Advantage, managed Medicaid, ... put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work… more
- Adelante (Phoenix, AZ)
- Medical Assistant (Behavioral Health) - Phoenix, AZ Job Details Job Location Adelante Healthcare West Phoenix - Phoenix, AZ Position Type Full Time Education Level ... from accredited school Job Category Health Care Description POSITION SUMMARY The Medical Assistant provides direct patient care and assist all patients and their… more
- Travelers Insurance Company (Phoenix, AZ)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- Molina Healthcare (Chandler, AZ)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management +… more
- Evolent (Phoenix, AZ)
- …improving healthcare quality.** + **Computer proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or ... for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in **Performance… more
- Sonora Quest (Chandler, AZ)
- …one special project identified with department management. Exhibits awareness of medical /legal consequences of professional actions. May assist in new employee ... and specimen integrity. **MINIMUM QUALIFICATIONS** + Bachelor's Degree in medical laboratory science/ medical technology, **OR** + Bachelor's degree… more