• Utilization Review RN PRN

    Saint Luke's (Kansas City, MO)
    …and follows through on process. + Documents communication and work in electronic medical record . + Works with physicians and members of the multidisciplinary ... RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through utilization review and management. This position includes… more
    Saint Luke's (08/21/25)
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  • Behavioral Health Medical Director…

    Humana (Concord, NH)
    …management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present ... health topics to the clinical operations team and healthcare organization. The Medical Director's work includes computer based review of moderately complex… more
    Humana (08/09/25)
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  • Executive Medical Director, Clinical…

    Regeneron Pharmaceuticals (Tarrytown, NY)
    …leading study start-up, directing and guiding study team execution, data cleaning, medical review , database locks, handling health authority responses are also ... The Executive Medical Director, Hematology, will provide overall clinical scientific...if you have the following:** + Demonstrated consistent track record in a range of leadership roles that include… more
    Regeneron Pharmaceuticals (08/15/25)
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  • Outpatient RN- Family Medical Group

    Trinity Health (Rensselaer, NY)
    …Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record . Review and update medication list to ensure accurate ... and complete list in electronic medical record (EMR) available for provider review and submission. Complete referrals and tracks patients' compliance. … more
    Trinity Health (07/26/25)
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  • Medical Policy Director

    Commonwealth Care Alliance (Boston, MA)
    …and develop recommendations for coverage + Manage the development of new and review of existing medical necessity guidelines by working closely with clinical ... by management **Operational Policy Governance: Oversee the governance structure for medical policy review and approval, ensuring transparency, consistency, and… more
    Commonwealth Care Alliance (08/31/25)
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  • Medical Director

    VCA Animal Hospitals (Sacramento, CA)
    … in such circumstances and revises protocols when appropriate. + Along with the RMD, medical record review of associate DVM's as needed. + Determines in ... practices in Northern California, is looking for a **Specialty Medical Director** to lead our growing team. VCA SVRC...performs yearly associate DVM reviews + Participates in yearly review of lead technician (s) with HM + Supports… more
    VCA Animal Hospitals (08/08/25)
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  • Medical Director - Acute Rehab Team

    Humana (San Juan, PR)
    …to operationalize this knowledge in their daily work specifically for DSNP. The Medical Director's work includes computer-based review of moderately complex to ... complex clinical scenarios, review of all submitted clinical records , prioritization of daily work, and communication of decisions to internal associates. The… more
    Humana (09/05/25)
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  • Medical Director - Care Plus - Florida

    Humana (Jackson, MS)
    …and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to ... complex clinical scenarios, review of all submitted clinical records , prioritization of daily work, communication of decisions to internal associates, and… more
    Humana (09/04/25)
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  • Associate Medical Director

    Elevance Health (Atlanta, GA)
    **Clinical Operations Associate Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit Management/Utilization Review ** _A proud ... medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or policy… more
    Elevance Health (09/04/25)
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  • Medical Records Assistant - SCI Camp…

    Commonwealth of Pennsylvania (PA)
    …with diagnostic-related group assignment according to standard nomenclature and classification systems. Review medical records for completeness and accuracy ... page (https://www.employment.pa.gov/Additional%20Info/Pages/default.aspx) . + Yes 05 WORK BEHAVIOR 1 - MEDICAL CODING AND RECORDS REVIEW Code diseases,… more
    Commonwealth of Pennsylvania (09/03/25)
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