- Highmark Health (Lansing, MI)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Lansing, MI)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Lansing, MI)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Elevance Health (Dearborn, MI)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- Humana (Lansing, MI)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Evolent (Lansing, MI)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- University of Michigan (Ann Arbor, MI)
- Hospital Care at Home Medical Director and Clinical Faculty Apply Now **Job Summary** The Division of Hospital Medicine - Michigan Medicine is seeking board ... Care at Home (HCAH) Program. **What You'll Do** The Medical Director of Hospital Care at Home...Serves as the dyad partner to the HCAH administrative director for day-to-day operational management of the… more
- Humana (Lansing, MI)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Grifols Shared Services North America, Inc (Muskegon, MI)
- …in more than 110 countries and regions. The primary responsibility of the MSL Field Director is the management , performance, and coaching of a team of MSL direct ... (MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy,… more
- ChenMed (Warren, MI)
- …is a transitional position towards becoming a center clinical P&L leader (ie, Senior Medical Director [SMD]) in the organization. The incumbent Center Medical ... The CMD may be simultaneously completing PCP Black Belt Training and Mastering the Medical Director Essentials within a combined and accelerated PCP and … more
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