- Molina Healthcare (MI)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight ... audit projects and deliverables related to accurate billing and coding . This role also works with the Health Plan...source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of… more
- CVS Health (Austin, TX)
- … medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide clinical support and ... the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical ...the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure… more
- Humana (Baton Rouge, LA)
- **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...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and… more
- Diversicare Healthcare Services & Diversicare Ther (Etowah, TN)
- …us! **Exciting Opportunity: Join Diversicare as an MDS Coordinator- RNAC and Director of Care Coordination.** Diversicare is seeking a dedicated MDS Coordinator ... Benefits:** Enjoy a competitive benefits package, including competitve salary, medical /dental/vision coverage, an excellent 401k plan, tuition reimbursement, and… more
- Humana (Raleigh, NC)
- … Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by members ... caring community and help us put health first** The Medical Director actively uses their medical...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance,… more
- Humana (Carson City, NV)
- **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
- Intermountain Health (Denver, CO)
- …Credentialing and Privileging documentation (hospital), Credentialing and Scope of Practice ( Medical Group), Consultation and Referral Plan (DOPL) or other similar ... this position is accountable to: deliver optimal patient care through effective clinical practice; education of the patient, patient's family, clinical staff,… more
- Highmark Health (Phoenix, AZ)
- …**JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and knowledge to the team. They support ... clinical team members for operational guidelines. The incumbent must have an understanding of medical coding (ICD-10, CPT, HCPS) as medical coding … more
- ThermoFisher Scientific (Greenville, NC)
- …oversight of all contracted services. **Discover Impactful Work:** The Associate/ Medical Director provides medical oversight of clinical trials to ensure ... industry; Or + Direct experience in safety/Pharmacovigilance (comparable to 2 years) **For Medical Director Level:** + MD or equivalent required. Active … more
- Intermountain Health (Billings, MT)
- **Job Description:** Medical Group Medical Director of Specialty Care in Montana Market, Billings is a leadership position reporting to and collaborating ... sustain healthy relationships among providers and Intermountain Health. The Medical Director must be a patient centric...AOA Board Certification in a relevant specialty. + Active Medical Licensure + Minimum two years of clinical… more