- Mount Sinai Health System (New York, NY)
- **Job Description** ** Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote** The Director , Pre Appeals ... and coordination of care to improve patient outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management, and… more
- Evolent (Phoenix, AZ)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... cardiology to help ensure the delivery of high-value, evidence-based...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Montgomery, AL)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology , Field Medical Director you will be a key member of the ... Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Elevance Health (Miami, FL)
- …clinical domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical ... **Clinical Operations Medical Director ** ** Medical Oncology**...medical necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals … more
- Aspirus Ironwood Hospital (Wausau, WI)
- …join us as we demonstrate those values Every. Single. Day. Aspirus Health Plan is seeking a Director - Medical Director to join our team in Wausau, WI! The ... Medical Director is responsible for conducting day-to-day medical ...role involves providing support and consultation for utilization management ( medical and pharmacy), appeals , medical … more
- Elevance Health (Houston, TX)
- …clinical domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical ... **Clinical Operations Medical Director ** **Carelon Medical ...medical necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals … more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Director Medical Affairs Operations- Medical Staff Services -Full-Time -Days (Remote)** _Our flexible remote opportunities offer an ... balance as well as decrease annual commuting expenses_ The Director , Medical Affairs Operations, serves as a...Staff Bylaws, Policies, Corrective Actions, FPPE, OPPE, Hearing & Appeals , etc.) is required. + 10+ years progressive experience… more
- Mount Sinai Health System (New York, NY)
- …(MSHS) is responsible for hospital-based Billing and Accounts Receivable performance across the medical center. The Senior Director will report to the Vice ... **Job Description** **Senior Director , Patient Financial Services (Backend) Corporate East 42nd...department such as coding, IT, clinical service areas and appeals to ensure seamless end-to-end revenue cycle performance. +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Associate Director Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days** Ensures maximization of Reimbursement ... Party Payers, ensuring the accuracy of data. + Prepares appeals to various Third Party Payers, stating the Institutions...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- …to the payor, as needed, coordinating direct communication between physician and payor Medical Director as required. 16. In psychiatry, the CM will document ... reviews in Canopy. 5. Supports the mission, vision, philosophy and goals of the Medical Center. 6. Case Management: The CM process will include: 1. Assessment of the… more
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