• Director Pre Appeals Management-HSO…

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote** The Director , Pre Appeals ... and coordination of care to improve patient outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management, and… more
    Mount Sinai Health System (11/01/25)
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  • Field Medical Director

    Evolent (Helena, MT)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... cardiology to help ensure the delivery of high-value, evidence-based...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
    Evolent (11/27/25)
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  • Cardiology Medical Director

    Elevance Health (New York, NY)
    …cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology._ The ** Medical Director , Cardiology ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This...medical necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals more
    Elevance Health (11/12/25)
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  • Field Medical Director

    Evolent (Helena, MT)
    …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology , Field Medical Director you will be a key member of the ... Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
    Evolent (11/27/25)
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  • Medical Director - Medical

    Elevance Health (Los Angeles, CA)
    …clinical domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical ... **Clinical Operations Medical Director ** ** Medical Oncology**...medical necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals more
    Elevance Health (11/14/25)
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  • Medical Director - Radiation…

    Elevance Health (FL)
    …clinical domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical ... **Clinical Operations Medical Director ** **Carelon Medical ...medical necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals more
    Elevance Health (11/05/25)
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  • Director Medical Affairs Operations-…

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Director Medical Affairs Operations- Medical Staff Services -Full-Time -Days (Remote)** _Our flexible remote opportunities offer an ... balance as well as decrease annual commuting expenses_ The Director , Medical Affairs Operations, serves as a...Staff Bylaws, Policies, Corrective Actions, FPPE, OPPE, Hearing & Appeals , etc.) is required. + 10+ years progressive experience… more
    Mount Sinai Health System (10/19/25)
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  • Assistant Director of Development- Data…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Development and Fundraising** **Assistant Director of Development-Data Services-Development & Fundraising-Corporate- Full-Time-Days- 150 East ... to travel to East 42nd Street Office as need. Reporting to the Director , Business Intelligence and Analytics, the Assistant Director manages and participates… more
    Mount Sinai Health System (10/07/25)
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  • Senior Director , Patient Financial…

    Mount Sinai Health System (New York, NY)
    …(MSHS) is responsible for hospital-based Billing and Accounts Receivable performance across the medical center. The Senior Director will report to the Vice ... **Job Description** **Senior Director , Patient Financial Services (Backend) Corporate East 42nd...department such as coding, IT, clinical service areas and appeals to ensure seamless end-to-end revenue cycle performance. +… more
    Mount Sinai Health System (11/11/25)
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  • RN/Case Manager-MSH-Case Management-FT-Days

    Mount Sinai Health System (New York, NY)
    …to the payor, as needed, coordinating direct communication between physician and payor Medical Director as required. f. In psychiatry, the CM will document ... Supports the mission, vision, philosophy and goals of the Medical Center. 2. Case Management: The CM process will...current insurance coverage. 5. Collaborates and participates in the appeals process with all members of the interdisciplinary team.… more
    Mount Sinai Health System (11/26/25)
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