- Conduent (Baton Rouge, LA)
- … field?** **Are you eager to learn new skills and help adults in need?** As a ** Medical Benefit Review Services Associate, Region 3** , you will help ... Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100...medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic… more
- Travelers Insurance Company (Baton Rouge, LA)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/ benefits /… more
- Sedgwick (Baton Rouge, LA)
- …review process including making a recommendation of specialty for the Independent Medical Review process. + Developing and delivering training materials and ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr VP Medical Director...Human Resources with ADAAA and FMLA support that require medical expertise; to adhere to service delivery… more
- Humana (Baton Rouge, LA)
- …management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present ... to the clinical operations team and healthcare organization. The Medical Director's work includes computer based review ...Typically reports to an Associate Vice President of Health Services , Lead, or Corporate Medical Director, depending… more
- Humana (Baton Rouge, LA)
- …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 ... coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may… more
- Evolent (Baton Rouge, LA)
- …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...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
- Evolent (Baton Rouge, LA)
- …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...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
- Evolent (Baton Rouge, LA)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
- Evolent (Baton Rouge, LA)
- …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...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
- Humana (Baton Rouge, LA)
- …provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review ... to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other… more
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