- Provider Solutions & Development (Klamath Falls, OR)
- … Medical Oncologist or Hematologist/Oncologist to join its team as an Oncology Medical Director in Klamath Falls, Oregon. This position is a hybrid production ... a regular basis for the performance and discharge of duties and responsibilities as the Medical Director . **Schedule:** + Monday through Friday 8 am to 5 pm… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Corp Real Estate Services ... Offers may vary depending on the circumstances of each case. **Summary:** The Director of Corporate Real Estate leads strategy, planning, and execution of real… more
- CVS Health (Frankfort, KY)
- …claims processing, contractual oversight, formulary management and updates, medication utilization review , prior authorization processes in alignment with ... in all state meetings regarding pharmacy program initiatives, new legislation, Drug Utilization Review (DUR) and formulary/guideline changes. + **Provider and… more
- CVS Health (Frankfort, KY)
- …**Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience. -Electronic medical systems/record experience. -Managed Care ... and every day. **Position Summary:** Ready to take your Medical Director skills to the next level...responses to members and providers related to precertification, concurrent review , and appeal request. This position is primarily responsible… more
- Evolent (Jackson, MS)
- …timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
- Blue KC (KS)
- …to administrative medicine + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, ... a major program or functional area within Medical Management, eg, medical policy, credentialing, utilization management, case management, patient centered … more
- Elevance Health (Walnut Creek, CA)
- …and external physicians. + Applies clinical knowledge and skills to utilization review processes. + Adheres to medical policies and clinical guidelines. + As ... **Behavioral Health Medical Director - Child Psychiatrist** Location: This...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Molina Healthcare (Green Bay, WI)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies… more
- Select Medical (Madison, WI)
- …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management** $10,000 Sign On Bonus...in social work and minimum three (3) years of medical case management or similar experience._** **Previous case mangement… more
- Munson Healthcare (Traverse City, MI)
- …CARE TEAM! Full-Time | Monday-Friday | No Call Munson Healthcare is seeking a Medical Director for Wound Care to oversee clinical operations, provide direct ... of medical services. In this position, the Medical Director is responsible for the oversight...the total needs of the patient. + The proper utilization of appropriate treatment for patients. + The necessary… more