- Elevance Health (New York, NY)
- … medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or policy ... **Clinical Operations Medical Director** **Carelon MBM** **Virtual:** This role enables...CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures and interventions listed… more
- Humana (Indianapolis, IN)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Evolent (Helena, MT)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Helena, MT)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Trinity Health (Albany, 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. + Review … more
- 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. Review … more
- Evolent (Helena, MT)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...MD review process to reflect appropriate utilization and compliance with… more
- Xeris Pharmaceuticals, Inc. (Chicago, IL)
- …ensuring timely and accurate delivery of high-quality documents. + Provides detailed medical editing review of draft and final documents prepared by ... on processes, templates, and other business needs within the medical writing function. + Coordinate and/or manage review... medical writing function. + Coordinate and/or manage review cycles to triage, incorporate, and resolve team comments,… more
- Evolent (Sacramento, CA)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Helena, MT)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...MD review process to reflect appropriate utilization and compliance with… more