- Humana (Harrisburg, PA)
- …topics to the clinical operations team and healthcare organization. The Medical Director 's work includes computer based review of moderately complex to ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Harrisburg, PA)
- …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...represents Humana at Administrative Law Judge hearings; exercises independent clinical judgment and decision making on complex issues regarding… more
- Humana (Harrisburg, PA)
- …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...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- CVS Health (Harrisburg, PA)
- …/ Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding, and reimbursement expertise ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...directing case management when necessary. The Medical Director will act as a business and clinical… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation...clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Genesis Healthcare (Wyncote, PA)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time team members. We offer Dental and ... team members. + **Support for New Grads:** Our Powerback Clinical Mentorship Program kicks off on day one, helping...Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of… more
- 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … 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