- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The VP Medical Director of Clinical Programs will manage the Health Plan Medical ... quality programs and outcomes, and programs to manage medical utilization trends such as inpatient, Emergency...areas of MHPC, as needed + Assists the Market Medical Director for building and deepening relationships… more
- CVS Health (Columbus, OH)
- …and consistent responses to members and providers. + As a Medical Director you will focus primarily on overseeing utilization review and quality assurance ... medical license without encumbrances in one of these states.** + In the Medical Director role you will provide oversight for medical policy… more
- Evolent (Raleigh, NC)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... developing cardiovascular programs that include improvements to clinical effectiveness of utilization management ( UM ) and risk-based models.** + Process… more
- Provider Solutions & Development (Burbank, CA)
- Providence St. Joseph Medical Center is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in ... You will work closely with the physician leadership, the Director of Care Management, and executive leadership; in particular...* Ability to effectively communicate with, motivate, and assist medical staff leadership to adhere to utilization … more
- Molina Healthcare (New York, NY)
- …Board Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease… more
- Nuvance Health (Norwalk, CT)
- … utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. Develops ... utilization management and high-risk case management. Works collaboratively with the Director of transitions to ensure optimum utilization of Social Work… more
- CVS Health (Frankfort, KY)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... and the Southeast Region (FL, LA and WV). This Medical Director will be a "Work from...Independent Review Organization a Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience. -Electronic medical … more
- CVS Health (Annapolis, MD)
- …System eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management) experience *Active and current state medical license without ... have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical… more
- CVS Health (Sacramento, CA)
- …timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance ... resides in Pacific or Mountain Time Zone. In the Medical Director role you will provide oversight...including post-graduate direct patient care experience. **Preferred Qualifications:** Previous UM experience with a Health Plan / Payor. Board… more
- Fallon Health (Worcester, MA)
- …appeals review + Member appeals review + Pharmacy issues and referral requests + Medical director on-call coverage + Support the benefits and technology review ... process + Provide support for UM administrative infrastructure + Participate in the HP's strategic...practice medicine in MA (or licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management;… more