- 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- CVS Health (MI)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California,...Better Health Plan of Oklahoma. This UM (Utilization Management) Medical Director will be a "Work from… more
- CVS Health (MI)
- …PIP templates for submission. + Assists Senior Quality Manager and Director with coordination and implementation of interventions to increase HEDIS, CAHPS, ... quality into their strategic and operational plans. + Provides updates to Director and leadership on assigned projects in the Quality Improvement work plan;… 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Integra Partners (Troy, MI)
- The Senior Medical Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is ... require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads medical… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with… 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Lansing, MI)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...internal teaching conferences, and other reference sources + Learns Medicaid requirements and understands how to operationalize this knowledge… more
- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the ... and determining the best course of action. The Corporate Medical Director provides medical interpretation...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more