- Highmark Health (Lansing, MI)
- …Inc. **Job Description :** **JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and ... **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing clinical criteria… more
- Humana (Lansing, MI)
- **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 ... Medical Director work assignments involve moderately complex to complex issues...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Integra Partners (Troy, MI)
- …Medical Director (s), ensures consistent application of criteria, leads medical policy development, maintains compliance with NCQA and regulatory ... The Senior Medical Director (Senior MD) serves as...physician leader who excels in clinical operations, regulatory compliance, medical policy , cross-functional collaboration, and representing Integra's… more
- Humana (Lansing, MI)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex...value based care in accordance with Medicare and Humana policy . All work occurs within a context of regulatory… more
- Gentiva (West Branch, MI)
- …Transform Care through Compassionate Hospice Leadership.** We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert ... substances. + Hospice and Palliative Medicine board certification and/or Hospice Medical Director Certification Board certification preferred. + Current Medicare… more
- McLaren Health Care (Davison, MI)
- The Medical Director is a physician contracted by Hospice who assumes overall responsibility for the medical component of the Hospice's patient care program. ... The Medical Director is a member of the...and other committees as requested. * Responsible for the medical component of the hospice program within policy… more