- Humana (Jefferson City, MO)
- …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
- Blue KC (MO)
- …in FACETS UM system in accord with UM concurrent review guidelines. Consults with Medical Director on cases outside medical policy, notifies providers and ... accord with medical policy. Opens case and follows NCQA case management standards. Documents transplant authorization, issues authorization letters, and follows… more
- Humana (Jefferson City, MO)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
- Centene Corporation (Jefferson City, MO)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Humana (Jefferson City, MO)
- …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Centene Corporation (Jefferson City, MO)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...state, corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the… more
- Blue KC (MO)
- …financial assistance** **Employee discount program** **Job Description Summary:** The Lead Medical Director actively uses their clinical training, experience, ... level of care, and/or requested site of service should be authorized. The Medical Director will apply various clinical policies, state and federal guidance,… more
- Humana (Jefferson City, MO)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- BJC HealthCare (St. Louis, MO)
- …work experience) **Additional Information About the Role** ** Director , Revenue Cycle Management for BJC HealthCare** _Oversight of the claims /billing team to ... million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional… more