- CVS Health (Tallahassee, FL)
- …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... outcomes. * Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and other… more
- CVS Health (Austin, TX)
- …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 ... Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia. This Medical Director will be a "Work from Home" position primarily supporting… more
- CVS Health (Charleston, WV)
- …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, KY and LA). 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
- Elevance Health (Denver, CO)
- ** Medical Director -PSCCR** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... an accommodation is granted as required by law. The ** Medical Director -PSCCR** is responsible for the administration...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- CVS Health (Topeka, KS)
- …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
- UCLA Health (Los Angeles, CA)
- …lead the development, evaluation, and implementation of multiple clinical programs and medical services with an emphasis on optimizing Utilization Management for ... will: + Oversee the development and execution of multiple UM processes and workflows, while continuously identifying and evaluating...years of executive leadership experience with a focus on Utilization Management for a medical group, IPA,… more
- Tufts Medicine (Burlington, MA)
- …cooperation with multiple revenue cycle and hospital departments, such as Coding, Utilization Management ( UM ), Case Management, Quality and Physician advisors ... Overview** The position is responsible for CDI program strategy and oversight. The Director will partner with the Senior Director , Clinical Revenue Cycle to… more
- ChenMed (Margate, FL)
- …We're rapidly expanding and we need great people to join our team. The Medical Director , Center is specifically responsible for executing the ChenMed Way and ... core model in his/her assigned center. Under the direction of the Market Chief Medical Officer (MCMO), the Medical Director , Center will directly supervise,… more
- Catholic Health Services (Melville, NY)
- …Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management ( UM ) committees. Supervises the Facility Physician ... Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation.… more
- Sharp HealthCare (San Diego, CA)
- … medical management activities to include tracking, trending and analyzing UM data. Works in collaboration with regional medical directors, ambulatory ... under the direction of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years Experience in… more